Greetings! This is a brief update to various healthcare issues which have been discussed recently.

Joint House and Senate Long-Term Care Study Committee

The Joint Long-Term Care Industry Study Committee met for an “organizational” meeting on Tuesday, October, 10, 2000 to discuss various issues relating to caring for Georgia’s citizens on a long-term basis. Members of this Committee, which is co-chaired by Sen. Harold Ragan and Rep. Jack West, include Mr. Martin Miller, Ms. Becky Kurtz, Mr. Nevin Jones, Ms. Genia Ryan, Ms Evelyn Thompson, Dr. Judith Stillion, Ms. Gina Shoemaker, and Mr. Billy Small.

This Committee discussed several difficulties associated with recruiting and retaining nursing staff who are employed by nursing homes and assisted living facilities. These same difficulties plague hospitals, home health agencies, and other healthcare related entities. Some of the difficulties cited by the Committee included lack of advancement in jobs, low pay (higher wages at some fast-food restaurants), low job satisfaction, no rewards given to those with high performance, long hours, etc.

One Committee member explained that Georgia had become the fifth fastest growing state in terms of elderly population members. Thus, demands on the long-term care needs were going to expand. Many will need assistance with their ADLs (activities of daily living) such as bathing, dressing, eating, etc.

Rep. Jack West noted that in Georgia, there are 139,546 licensed registered nurses and of these 52, 927 are inactive. Also, there are 59,376 licensed practical nurses in Georgia and 30,217 of these are inactive. It was also pointed out that these numbers are somewhat skewed because many RNs and LPNs, who keep their licenses current, work in administrative settings and are no longer active in hands-on care. CNAs (certified nursing assistants) are also in short supply; many healthcare entities believe that these are the true backbone of the healthcare staff.

There was some discussion at this meeting on how facilities could “harvest” CNAs for additional training. This would perhaps give these CNAs a mechanism for advancement and a ‘perk’ for employment. Some thought that CNAs could be great candidates for education and training expansion by encouraging them to pursue an LPN or RN designation. Some facilities will currently pay for the training of a CNA. It was also pointed out that underlying educational requirements for persons to pursue healthcare training are also problematic: many would pursue higher education but cannot meet entrance requirements. There are problems associated with these facilities paying for such training. After the training, the CNA has no requirement to remain at that facility for any length of time to “pay back” the facility for their employment. These facilities not only pay for the training but also pay a wage to that person training to become a CNA.

Representatives from some facilities on the Committee also pointed out additional problems which bleed over to staffing issues. These problems include higher costs for liability insurance, facility’s inability to pay its workers’ health insurance premiums due to rising costs of healthcare, number of workers’ compensation claims filed, and the number of lawsuits filed against facilities for the maltreatment of residents/patients.

Committee members also raised other issues to be addressed such as: 1) assessing the needs of patients; 2) tracking the informal caregivers of persons (for instance persons who care for elderly parents at home); 3) looking at persons with disabilities who are under the Independent Care Waiver Program and the costs associated with their needs; 4) examining other special populations such as those with Alzheimer’s Disease; 5) looking at the young who need long-term care but have no alternative except a nursing home environment (an example given was a young 29 year old male); 6) examining the quality of care being provided; 7) using “forgiveable” loans for students who wish to pursue healthcare-related careers; and 8) tracking the utilization of bed space (currently, there are waiting lists in most if not all nursing homes).

No additional meeting of this Committee has been set, but the Committee is currently expected to provide a report of its findings on or before December 1, 2000.

Joint House and Senate Hospital Indigent Care Funding Study Committee

The members of the Joint Hospital Indigent Care Funding Study Committee have been named. These members include Sen. Jack Hill, Sen. Eddie Madden, Sen. Eric Johnson, Sen. Carol Jackson, Sen. Ed Harbison, Rep. Terry Coleman, Rep. Richard Royal, Rep. Kathy Cox, Rep. Ben Harbin, Rep. Sistie Hudson, and representatives from Floyd Medical Center, The Medical Center (Columbus), Memorial Health System (Savannah), and Camilla Hospital (affiliated with Archbold Health System). This Committee was established pursuant to SR 556 and is to prepare a report of its findings on or before December 15, 2000. This Committee will look at issues surrounding Georgia’s hospitals relating to indigent and charity care as well as bad debt attributed to such care. Further, it would appear that this Committee will also look at issues relating to the uninsured, services provided to Medicare and Medicaid patients which are reimbursed at less than the amount it costs to treat such patients, Indigent Care Trust Fund issues, closures of hospitals, losses to hospitals for the provision of care due to uncompensated care costs, ensuring hospitals support the local economy as they are a good source of jobs to citizens, etc. No meeting date has been set for this Committee to hold its first meeting.