Today was Presidents’ Day and also the 22^nd Legislative Day. The Georgia General Assembly reconvened today after working on budget issues over the weekend. Today at the Capitol, the Junior Leagues in Georgia provided lunch to the Legislators – again proving that it is the largest of the all-women lobbying groups. Here are a few highlights of the day:

SB 464 – This is the pinklining legislation being carried by Sens. Stokes, Thompson, and Tanksley for the Governor. It would amend O.C.G.A. § 33-6-4 and would prohibit insurance companies from discriminating against domestic violence victims.

SB 467 – This "ethics" bill relates to the acceptance of a gratuitous transfer from a registered lobbyist or a person, organization, or entity represented by a registered lobbyist during a legislative session. This bill was referred to the Committee on State and Local Governmental Operations. It was authored by Sens. Land, Stephens, Guhl, and others.

SB 475 – This amends O.C.G.A. § 33-20A-6 concerning the prohibition of certain financial incentive programs by managed care plans and would further prohibit managed care plans from restricting a participating physician from providing in-patient services in a participating facility to an enrollee if those services are "medically necessary and covered services under the managed care plan." Also, the bill requires that a managed care plan is to not deny or delay payment to those participating physicians for such medically necessary in-patient hospital services provided by that physician provided that the services are covered under the managed care plan. This has been dropped in the hopper by Sen. Nadine Thomas and Sen. Don Thomas.

SB 479 – Sens. Madden, Meyer von Bremen, Smith and others have introduced this amendment to Chapter 2 of Title 37 of the Code regarding the administration of mental disability services in order to provide for a state ombudsman and for community ombudsmen for mental health, mental retardation, and substance abuse. The state ombudsman would be a full-time state employee under the supervision and direction of the consumer’s insurance advocate of the Governor’s Office of Consumer Affairs. The state ombudsman would contract with one or more non-profit corporations to operate a community ombudsman program in each of the current Regional Board areas; the non-profit would not be allowed to contract unless that corporation has some experience in advocacy for patients and has demonstrated an ability to establish, implement and maintain a community ombudsman program. This community ombudsman would have to recruit and train volunteers and employees to carry out the functions of ombudsman program; it would have to educate the public about the program; it would mediate and advocate on behalf of the patients/clients as well as their families; it would assist with problems brought to the ombudsman's attention by the patient/client or family member regarding a provider (it would also have to notify the complainant and the provider of the completion and findings and the provider would be allowed to respond within 15 days of receipt of the findings and the ombudsman would also make recommendations to the service provider no sooner than 30 days after the transmission of the findings and the provider would also respond if any actions had been taken within 15 days as well as provide reasons for not following any of the ombudsman’s recommendations); it would also have to maintain records of activities and prepare a report to the state ombudsman on a quarterly basis; and it would also have to conduct reviews by going to the premises of a provider where services are provided. The bill prohibits any discrimination or retaliation against a patient, employee of a provider, or other person due to a complaint or in the provision of information in good faith to the state ombudsman – if a Regional Board or a Community Service Board violates this, the board member would be subject to removal and if a provider discriminates or retaliates, then the provider would have its contract terminated and be required to pay a penalty of at least $500.00 or be suspended without pay for at least two months or be terminated from the employment of the provider. The community ombudsman in each of the areas will be required to provide a list to the state ombudsman of all complaints investigated and any findings, responses and recommendations made as a result. These lists would not be subject to public records disclosure or subpoena or discovery proceedings per Article 4 of Chapter 18 of Title 50. The bill also eliminates the Code section at 37-2-5 regarding a Community Service Board member that may not also serve as a member of the Regional Board. Instead, a person would not be eligible to be appointed to a CSB if he or she was a member of the Regional Board which services the area in which that CSB is included or an employee of that CSB or employee or Board member of any private or public group, organization or service provider that contracts with or receives funds from that CSB. Additionally, no person may serve on a CSB if that person’s spouse, parent, child, or sibling is a member of that CSB or is a member, employee, or Board member as defined in O.C.G.A. § 37-2-5 (A) and (B).

HB 1538 – This is another bill which has been introduced to amend Article 1 of Chapter 24 of Title 33 of the Code which would require health insurance plans to cover the costs of a child’s craniofacial care. Rep. Sharon Trense and others authored this bill which has now been referred to the House Insurance Committee.

HB 1547 - Reps. Purcell, Greene, Ray, and Floyd have dropped this bill to amend the Tax Code at O.C.G.A. § 48-7-29 regarding income tax credits for rural physicians. The bill changes the qualifications for those tax credits. The bill has now been sent to the House Ways and Means Committee.

HB 1549 – Reps. Harbin, Channell, and Williams introduced this bill to amend the Tax Code at O.C.G.A. § 48-8-3 regarding an exemption with respect to the sale or use of prosthetic devices. This has also been referred to the House Ways and Means Committee.

HR 1058 – This is the House version of the Resolution to create the Joint Hospital Indigent Care Funding Study Committee. It was introduced by Rep. Sims and others and has been referred to the House Rules Committee.

HR 1079 – Rep. Stanley and others authored this Resolution to create the Commission on Psychiatric Medication of School-Age Children. This has also been referred to the House Rules Committee.

HR 1080 – The Resolution to urge the United States Congress to amend its provisions of the Social Security Act concerning the Medicaid program and the Medicaid Disproportionate Share Exclusion Exemption has now been assigned to the House Committee on Human Relations and Aging. This was introduced by Rep. Channell and others.

SB 290 – This bill authored by Sen. Hecht has now crossed over to the House. It amends Article 2 of Chapter 12 of Title 45 and proposes to enact the Georgia Mentoring Act of 2000. This has been referred to the House Committee on Education.

SB 315 – The "Terrell Peterson" Bill has also crossed over to the House and has now been assigned to the House Judiciary Committee. Originally, this was introduced by Sen. Nadine Thomas and others and would amend Article 1 of Chapter 11 of Title 15 (the Juvenile Code). It would allow a physician to take control of a child without parental consent if the child’s life or health was found to be in imminent danger.

The House passed the legislation that would expand eligibility of the PeachCare for Kids program for those families with children (from birth up to 18 years of age) and with incomes up to 235% of the federal poverty level. Rep. Mickey Channell presented this bill and fielded a number of questions from the various Republican members on how many additional children would be covered by the PeachCare program, income levels affected by this bill (what was the average amount of income), etc. Rep. Franklin offered an amendment to remove the language in the bill that would have required the Department of Education and the local school boards to become involved in identifying and enrolling children in the PeachCare for Kids program. Rep. Franklin’s amendment failed, and the bill passed and now proceeds to the Senate.

Also, in the House, a motion was made to engross HB 1538 regarding the health care coverage for a child's craniofacial care, which is the "outpatient and inpatient diagnosis of abnormal craniofacial structures of the body of a child caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease and treatment thereof." This bill was introduced by Rep. Trense and will amend Article 1, Chapter 24 of Title 33.

The Senate Appropriations Committee held a hearing this afternoon on the Supplemental Budget for 1999-2000. Sen. Hooks presented the bill to the Committee which then passed out HB 1162. This contains a $166 million tax cut to property owners, more than $200 million for education, an increase from the Governor’s request of $100 million for the Georgia Regional Transportation Authority to $120 million, money for the ports of Georgia, and $58 million in TANF funds. This bill now proceeds to the Senate Rules Committee.

The Senate Health and Human Services Committee met this afternoon with a lengthy agenda. The bills included SR 459, a Resolution creating the Joint Study Committee on the Prevention and Emergency Care of Injuries in Georgia. Sen. Walker presented this Resolution and the bill passed as amended (the two amendments related to the change from the Executive Vice President of the Georgia Hospital Association to the President of that Association and a reference to the Public Health and Preventive Medicine Committee of the Medical Association of Georgia which was changed to just a representative of the Medical Association of Georgia rather than a representative from a specific Committee). This Committee would be comprised of the following: 1) three members of the Senate, appointed by the President of the Senate; 2) three members of the House, appointed by the Speaker; 3) the Director of the Governor's Office of Highway Safety or such person's designee; 4) the Director of the Division of Public Health of the Department of Human Resources or such person's designee; 5) the President of the Georgia Hospital Association or such person's designee; 6) a representative of the Medical Association of Georgia or that person's designee; 7) the Executive Director of Safe Kids of Georgia or that person's designee; 8) the Director of the Children's Trust Fund or that person's designee; and 9) the Director of the Injury Control Center of the Rollins School of Public Health or that person's designee to be appointed by the Governor with such person's consent.

The Committee also heard SB 391 regarding psychologists who have been subject to a board investigation as the result of a complaint or report to the Board. Sen. Hecht presented the bill regarding disclosure information of complaints made against psychologists. There was no discussion on the bill and it passed out of the full Committee. The bill would require that a copy of the complaint or report be furnished to the psychologist "as soon as practicable after the investigation is initiated but in any event prior to or at the same time as the delivery of a subpoena for the production of documents." If the psychologist is the subject of an investigation that has been initiated by the Board at its own initiative, a written statement of the acts or omissions being investigated is to be furnished to the psychologist "as soon as practicable after the investigation is initiated but in any event prior to or at the same time as the delivery of a subpoena for the production of documents." The Board may delay getting information to the psychologist if it determines that the nature of the investigation requires that its existence not be disclosed to the psychologist, but in no event shall such copy or statement be provided later than the delivery of a subpoena for the production of documents to the psychologist. In instances when the Board is required to furnish a copy of the complaint or report or statement of the acts or omissions being investigated pursuant to this subsection, then the Board is to make no determination of whether to impose a sanction under this Code section until at least 30 days after such copy or statement has been furnished to the psychologist. During that time, the psychologist may respond in writing to the Board regarding the copy or statement so furnished. After an investigation has been completed and the Board has determined that no action shall be initiated against the psychologist, the Board is to, within 30 days of the closure of the file, advise the psychologist in writing that the matter is closed and that no further proceedings are pending.

SB 381 was also taken up in the Health and Human Services Committee concerning grants made to rural hospitals. This amends the Rural Hospital Authorities Assistance Act at O.C.G.A. § 31-7-94.1 allowing rural hospitals to receive grants for the following: 1) infrastructure development (facility renovation or equipment acquisition) but the amount granted to any qualified hospital may not exceed the expenditure thresholds that would constitute a new institutional health service requiring a certificate of need under Chapter 6 of Title 31 and the grant award may be conditioned upon obtaining local matching funds. (2) strategic planning (strategies for personnel retention or recruitment; development of an emergency medical network; or development of a collaborative and integrated health care delivery system with other health care providers) and the grant award may be conditioned upon obtaining local matching funds for items such as telemedicine, billing systems, and medical records. Maximum grants to any grantee are not to exceed $200,000. (3) nontraditional health care delivery systems (this would not include operational funds and purposes for which grants may be made under paragraph (1) or (2) above). In this section, the maximum grant to any grantee is to be $1.5 million. (4) maintenance and operation expenses of hospitals facing potential closure (the funds would have to be used to expedite the transition to include appropriate sizing and realignment of services for the demand within the hospital's service area) and the maximum that could be awarded in this category is $700,000. After the bill was presented, it passed out without any discussion. This bill now proceeds to the Senate Rules Committee.

SB 373 was also on the agenda and was presented by Substitute by Sen. Eddie Madden. The bill amends the Pharmacy Practice Act found at Chapter 4 of Title 26. The bill would amend the ways in which pharmacy licenses are obtained and would require that a pharmacist "in charge" be listed on an application and the pharmacy owner is also to have the primary responsibility for the non-pharmacy practice concerning the management of the pharmacy (employing a number of adequate pharmacists, etc). Concerns were raised about the bill, such as those by Sen. Nadine Thomas regarding an amendment which would allow a designated person, licensed under Title 43 (physician, registered nurse, or licensed practical nurse) to have limited access to a pharmacy when a hospital, clinic, prison clinic or narcotic treatment program clinic or similar pharmacy is not open for business or a pharmacist is not available to fill a medication. Numerous amendments were offered including one to allow a pharmacist to dispense either a dangerous drug or controlled substance, upon receipt of drug order, from any healthcare practitioner, licensed in another state with a license in good standing. This would have broadened the language in the Substitute which would propose to allow a pharmacist to fill prescriptions only to a physician, dentist, podiatrist or veterinarian with a license in good standing from another state. Thus, this would have included physician's assistants, advanced practice nurses, etc. that had the right to prescribe in other states. This amendment failed to pass. Another amendment was offered that would have required pharmacists to fill certain brand name drugs (this was getting at the language in SB 239 that failed to pass out of the Committee previously). Commissioner Russ Toal testified before the Committee that such an amendment to require the use of brand name drugs could be very costly to the Medicaid program as well as the State Merit program. This amendment also failed to pass as the Committee needed more cost information. Another amendment was offered to amend O.C.G.A. § 26-4-4 that would allow the Board of Pharmacy to promulgate rules and regulations pertaining to the performance standards and communication of results of capillary blood tests. This amendment passed. The bill then passed out of the Committee by Substitute as amended.

SB 144 was also discussed at this meeting but no vote was taken. Sen. Mike Polak presented the bill regarding the amendment to Chapter 7 of Title 31 in order to create the "Consumer Centered System for Access to Long-Term Care Services Act." This allows the single point of entry of a person into the long-term services system by conducting intake, screening, information and referral of possible potential long-term care consumers and apprising those consumers of the array of services and providers available. Representatives of the Georgia Nursing Home Association opposed this bill stating that, in O.C.G.A. § 49-6-60, there is already a method in place for the implementation of coordination of community care that is in the hands of the Department of Human Resources. (DHR is supporting this legislation.) The Nursing Home representatives pointed to the Source Project which should be given the opportunity for success before implementing another layer or system. Also, in order to get Medicaid reimbursement for nursing home care, a person has to apply to the Department of Family and Children’s Services and such legislation, as the Nursing Home representatives argued, would simply cause delays for people trying to get assessments (pointing to the system in Arizona which has utilized a private entity to conduct such screenings).

The Health Facilities Subcommittee of the House Health and Ecology Committee also met this afternoon and passed out Sens. Madden, Hill, Hooks and Bowen’s bill amending the Essential Rural Health Care Provider Access Act. This would eliminate the exemption for health maintenance organizations. Thus, when reviewing an HMO’s request to either originate or expand an area of service into a rural area, the DHR Commissioner would be required to consider whether the HMO has demonstrated a willingness to grant reasonable consideration to essential rural healthcare providers in the negotiating and contracting process.

The Safe Place for Newborns Act was heard last week in the House Judiciary Subcommittee of General Law and Procedure. After an extensive rewrite of the bill, a Substitute has been proposed to HB 1365.

In the rewrite, a parent can leave a newborn at a medical facility, which is defined as a "specialty hospital, institutional infirmary, health center operated by a county board of health, or any building or facility where human births occur on a regular and ongoing basis which is classified by the Department of Human Resources as a birthing center, but shall not mean physicians’ or dentists’ private offices." Further, the parent would not be prosecuted for crimes outlined in O.C.G.A. § 19-10A-4 if: a) the parent leaves the child in the physical custody of an employee, agent, or member of the staff of a medical facility who is on duty (either a paid or volunteer employee); b) the newborn child was no more than one-week old; and the newborn child had not been physically abused. If the parent leaves the child, he or she would not be prosecuted for cruelty to a child, contributing to the delinquency, unruliness or deprivation of a child or abandonment of a child. DHR would be required to investigate and report to the General Assembly those children that are left with a medical facility. Further, DHR is to report the desirability and cost-effectiveness of a dedicated toll-free telephone line for providing information and answering questions from the public and employees, agents, staff members of medical facilities regarding the acts and consequences found in this Act. The immunity from liability of the medical facility when it or its employees accept such a child, as found in the original bill, has been removed from this Substitute. The medical facility would have to notify DHR though when the child was "medically ready for discharge" and once the notification is received by DHR, then DHR would have six hours to take physical custody.