Additional Budget Hearings were held today at the Capitol with the greatest portion of the hearings dealing with the Budget Recommendations for the Department of Human Resources.

Jeffrey Ezell presented the Teachers’ Retirement budget for FY 2001. This budget item has grown in size. There were $865 million in benefits paid in 1999 and $43 million in withdrawals made. There were $39 billion in assets as of December 1999. Membership in the system was 186,800; there were 43,700 retirees. Retiree payroll will exceed $1 billion. The average monthly benefit paid is $2,000. In the budget request, Teachers’ Retirement has asked for $3,270,000. Mr. Ezell also reported that the Investment Commission Director within the Teachers’ Retirement System is William Cary. One point of interest was that if a retired teacher returns to teaching in the system, he or she must be part-time or must not exceed more than 49% of time on the job.

Commissioner Audrey Horne presented the Department of Human Resources ("DHR") Budget for year 2001. Last year, DHR expanded mental health, mental retardation and substance abuse services and also worked hard on the provision of community-based services. The population in Georgia of people over 60 years of age is the largest growing population. Another area in which dollars have proved helpful is in the TANF dollars to pregnant women. Ms. Horne reported that redirections were cutting across every program in the 2001 Budget. Local health departments also were hit in redirects with a loss of $3.6 million. In January, 2001, the Bainbridge facility will close. DHR is working on trying to place those patients and staff and to make certain there are community placements and services when necessary.

As for additions and enhancements, Commissioner Horne reported that there would be additional money for community based services, chronic disease prevention, and child welfare. Child welfare is the number one priority at DHR. Ms. Horne is transferring 171 staff to Child Protection and is going to intensify child services in Fulton County, where there is the greatest need. Also, the Georgia Bureau of Investigation is working with DHR in training its staff on conducting investigations, collecting information, and the like. There will also be additional dollars provided to First Placement Best Placement. DHR is working on identifying children most at risk including those children that are in a substance abuse environment (such as with mothers addicted to drugs). It has been shown that substance abuse in families with small children often places the child in extremely dangerous surroundings and two-thirds of all child deaths (nationally) involve substance abuse in the child's home. DHR wants to make certain that referrals to services are appropriate and that children get the appropriate immunizations and medical assistance.

Commissioner Horne fielded numerous questions. Sen. Starr asked about the Community Service Boards ("CSBs"). Sen. Starr specifically asked about the firing of employees at CSBs and whether Medicaid was trying to abolish CSBs. Ms. Horne explained that she views CSBs as a major provider of services and hopes that DHR may be able to provide assistance when a CSB has financial difficulties.

Sen. Madden also questioned Commissioner Horne about CSBs and the fact that they had sustained a $15 million Medicaid cut (in reality a $38 million cut when federal dollars are added). Sen. Madden expressed concern about the waiting lists and the use of various monies – there previously was a $4,527,000 amount appropriated from State dollars and now there is a $5,251,882 amount coming from the Tobacco Settlement dollars. This is an approximately $800,000 cut in the State’s commitment as the "old" dollars were taken out of the 2001 Budget. Commissioner Horne indicated that many people had inquired about those numbers and she and her department are working with the Office of Planning and Budget on opportunities. Sen. Madden is also skeptical about the monies "saved" from the closure of the various State hospitals – it would appear that none of those dollars are going towards community-based services. There is also a transportation issue at some of the CSBs that serve multiple counties – this is especially so in rural areas of the State. Ms. Horne stated that she wants DHR to provide technical assistance to those facilities to help alleviate some of the transportation issues; she also wants to have continued discussions with Commissioner Toal about Medicaid funding.

Sen. Ragan asked about the transition process in closing the Bainbridge facility. Of the 129 in that facility, 59 of those patients require institutional care (many will be moved to Thomasville). He is also concerned about the community services available to serve the remaining patients. Commissioner Horne stated that DHR’s intent was to make public-private group homes an option. The transition team is focused and working on a resolution including looking at employment for the displaced staff. Sen. Ragan also asked about the very difficult cuts to county health departments and asked what DHR’s vision on this issue was. Ms. Horne assured Sen. Ragan that the cuts to the county health departments were difficult ones to make. Finally, he asked about the $50,000 item for the Center for Independent Living in middle Georgia. Ms. Horne stated that this would reduce the waiting list for about 130 people.

Rep. Holland inquired about the CSBs as well. He asked how DHR could keep the CSBs open and address their financial issues. Ms. Horne stated that she was committed to working on these and to get technical assistance for the CSBs as well as finding a way to manage the Medicaid cuts made last year. As for at-risk children or those needing early intervention, he asked what could be done. Ms. Horne stated that she is working on an "arsenal" as the Department of Family and Children Services ("DFACS") is not always the best responder. Rep. Holland also asked about the "chain of command" within DFACS. Ms. Horne stressed that early intervention is a voluntary program and requires parental training.

Rep. Mobley asked what the State was going to do to prevent strokes. Georgians need education on stroke warning signs. There are Tobacco Settlement dollars in the amount of $1.3 million for education but Ms. Mobley wants DHR to expend more. Mr. Horne stated that there were many things for DHR to look at relating to prevention issues and DHR is committed to preventing this from becoming a big issue.

Rep. Channell asked about the school nurses proposed. He asked how DHR was going to implement the program; how many nurses there would be; and was the State going to be the actual employer of these nurses or would that function be given to local hospitals. Commissioner Horne indicated that the Governor’s Office was planning to make the Department of Education responsible for the school nurse program and eventually the program would be moved to the Department of Education’s Budget. There would be a nurse for each school. DHR has not been told how it would be involved – support, backup, protocols, or providing direct services. Rep. Channell asked if DHR had specific plans to implement the program; Ms. Horne responded that DHR had developed complex, complete plans on how to get these nurses in place working with the public health departments.

Rep. Trense asked about drug testing of mothers giving birth at Grady Hospital and whether DHR is tracking these drug-addicted mothers when they leave the hospital. Commissioner Horne answered the question by stating that the data systems within DHR do not provide much data on the populations it serves. There has been a computer system in the planning stages for seven years; tracking is a tedious process and depends on the definition of "risk." Rep. Trense also asked about the 3% salary increases as well as lowering the caseloads of workers. Commissioner Horne indicated that the transfer of 171 workers would decrease the caseloads.

Commissioner Horne was also asked about the $131 million TANF surplus and what proposals might be in the works for those funds. Ms. Horne indicated again that she had no population-based information – such as who is leaving TANF, who is staying on TANF. DHR also needs to know what issues these TANF recipients might have for moving into the workforce, such as educational needs, physical needs, mental health needs, etc. There will be 8,500 persons reviewed.

Rep. Yates asked about the local health departments and reminded the Commissioner that those were the "first line of defense." He asked why all the Tobacco Settlement funds were for new programs rather than existing programs.

Rep. Smyre (some were referring to him as Preacher Smyre), solicited a round of applause from the audience in his questioning of Ms. Horne. He stated that mental retardation was an issue that Georgia needed to address; the State could not continue to cut community services and such cuts need to STOP. Rep. Smyre met recently with his local CSB director who was claiming to have to cut 100 jobs. Rep. Smyre argued that there needed to be a collaborative effort -–collectively – he wants to summon Commissioner Toal, Commissioner Horne, and key legislators to work on this problem. The State needs to return to HUMAN resources.

Rep. Cummings asked about the severely, emotionally disturbed children in the MATCH program. He urged Commissioner Horne to do something about the rate freeze which has been in effect for the last five years. Ms. Horne stated that DHR is working on the First Placement/Best Placement.

Sen. Hill asked about unified transportation and whether DHR was getting a process for feedback from those that participate in the non-emergency transportation program. He also asked about customer satisfaction as well as cost savings. Ms. Horne believes that involving communities at the start is the best way to work through this issue.

Sen. Dean also asked about the Tobacco Settlement funds and their uses – such as locally? Ms. Horne stated that many programs to be funded would actually be handled at the local level – such as the CCSP programs.

Rep. Sinkfield asked about the training being done on the 171 employees being transferred to Child Protection Services. Commissioner Horne indicated that some training has already been completed for some of these workers. The Child Protection Services Task Force will also delve into this issue and look at what would be appropriate based on practice and risk.

Rep. Buckner asked about the scoliosis screening, as required on the "health check" process, previously funded with greater State dollars. There has been a proposed cut;– Ms. Horne believes that the primary care providers would be able to make appropriate assessments of these children on a regular or routine basis. However, a point was raised that some of these children do not visit a primary care physician.

Rep. Manning also asked more questions about the CSBs and whether those were the safety net for the system or if DHR was the safety net. Ultimately, according to the Commissioner, DHR is responsible to provide the necessary services. Rep. Manning asked about the capability to hire and fire county DFACS workers. In the firing of a DFACS Director, the authority is given to the local DFACS Board but the termination letter will be sent by DHR.

Rep. Mueller asked some questions about the LCEW v. Olmstead case and why it was so imperative that the State take people out of institutions when there is a long waiting list for community services. Commissioner Horne stated that the decision in the Olmstead matter mandated that it reduce the number of people in institutions as well as those waiting on lists for services. The Commissioner said that the community placement of individuals currently in institutions does not reduce other resources available for taking people off the waiting lists.