October 27, 2000

For more information contact:

Stanley S. Jones, Jr.

404-817-6133

Greetings!  This Report contains information on two issues which will be heard during the 2001 Session:  ovarian cancer and long-term care needs.

Ovarian Cancer

 The House Study Committee on Ovarian Cancer met on October 20, 2000. 

Rep. Dorothy Pelote, Rep. Rene'e Unterman, and Rep. Carolyn Hugley are members of this Study Committee.  It was stressed that pap smears do not detect ovarian cancer.  There was also some discussion about whether there are new tests in the market to detect ovarian cancer (ultrasounds, sonograms, blood tests, etc.) and what accuracy was associated with such tests.  The Study Committee members would like to get information from the following:  Centers for Disease Control; Georgia Ovarian Cancer Alliance; American Cancer Society; Department of Insurance (what the insurance industry covers presently and what is required); Medical Association of Georgia  - an OB/GYN; oncologists (what options are in public domain and what treatment is successful); the Coalition on Ovarian Cancer; and the Office of Women's Health.

Rep. Pelote explained that she had run into some difficulty previously when she introduced a similar piece of legislation on this health issue.  The prior bill was an insurance mandate; the insurance industry defeated her prior legislation.  She stressed that her friends were dying from this deadly, silent killer.  Also, the Health Department in Savannah is apparently extremely interested in this disease.  However, there was no information distributed at this meeting about whether there was a high incidence of this cancer in the Savannah area. 

Rep. Hugley asked questions about whether this Study Committee would want to suggest legislation on the issue such as requiring insurance companies to cover screening, treatment, etc.  She also asked about whether parameters might be drawn around such legislation - such as requiring coverage for certain populations (age), etc.

The next meeting of this Study Committee will be held on November 13 and 14 in Atlanta beginning at 10:00 a.m.   There will also be a public hearing on this issue on December 4 in Savannah.   Currently, this Study Committee is scheduled to report back on this issue by December 1.  Due to getting a late start, they will be asking Speaker Murphy for an extension until the beginning of the year.

Long -Term Care

The Joint House and Senate Study Committee on Long-Term Care held a meeting on October 26, 2000.  Rep. Jack West and Sen. Harold Ragan are the co-chairs of this Study Committee.  A presentation was given by the co-chairs of the Governor’s Blue Ribbon Task Force on Long-Term Care. 

The Blue Ribbon Task Force reported that it had received responses from 1,100 surveys.  It found that there is an enormous demand on the system in Georgia.  Further, many with developmental disabilities and physical disabilities needed access to services.  Some are Medicaid eligible; some are not.  There are apparently 6,000 individuals who need support services who are not eligible for Medicaid.

There is no strong State plan in Georgia for people with mental illness.  Thus, these individuals also need to be able to access care and treatment. 

The Blue Ribbon Taskforce found that manpower is a huge issue.  Part of the problem is the difficulty and diversity of the clientele.  There are individuals who have physical and psychological needs who need case management and social services.  Thus, each case has its own set of differences and complexities.  It was reported that an average person of risk has four medical diagnoses and a psychiatric diagnosis.  Many also have behavior problems as well.

Many of these services are delivered by a paraprofessional.  Providers are caught in the quagmire of accepting a reimbursement too low for the service provided and thus cannot provide benefits to their employees.  Thus, there are additional issues such as these workers being uninsured and making demands on the State’s system in another manner.  Also, since these workers are being underpaid, many can obtain jobs in another setting where the pay is higher.  There is also a need for more licensed personnel.

This Taskforce recommended that the reimbursement system should have a differential depending on the intensity level of the case (and services needed).  The Taskforce also recommended:

1)      Standardizing definitions of services;

2)      Standardizing staffing to do services;

3)      Establishing reimbursement which reflects the services needed with improvements, adjustments, and refinements made to the system (this would include addressing the staff’s expectations such as full-time employees with a guaranteed 40-hour work week and benefits);

4)      Obtaining information from Commissioners of the Department of Community Health and Department of Human Resources on how monies are currently spent (with the goal of spending the State’s dollars more wisely); and

5)      Developing a linking mechanism to guarantee that higher trained staff is addressing those clients with the greater needs (an outcomes measurement system).

The Taskforce also discussed having a better registry of persons who are trained and qualified.  Currently, there is such a registry for the nursing home industry.  This registry has a question about whether the person has been adjudicated for an issue dealing with abuse to a client. 

The Taskforce also heard testimony at its hearings about the need for services from those who did not know services were available in the State.  Thus, a mechanism to get the information out to the public on availability of services is critical.

There was also some discussion on a pass-through type of reimbursement for employees.  This dealt with how to better pay workers in order to retain them.  South Carolina has been considering legislation which would give any additional reimbursement directly to the healthcare workers.  

Facilities, such as nursing homes, are also concerned about expending dollars to train workers only to have those workers leave their facilities once they receive training to seek employment in a setting where they receive higher pay and better benefits.  Nursing homes believe that there should be some way in which they can require that when they train such workers that they should be able to keep them for a certain amount of time.  There was also some discussion by the Study Committee on what could be done on licensing reciprocity – in some states, a course is not required prior to taking a test for licensure.  In Georgia, a Certified Nursing Assistant must take the course prior to sitting for the examination.   

There was also some discussion that long-term care facilities such as nursing homes, personal care homes and assisted living facilities should utilize senior citizens.  Many times these persons prove to be good, caring workers.

Prior to the next meeting of this Study Committee, there will be meetings held with two Subcommittees.  One Subcommittee will address nursing home and personal care home needs and the other Subcommittee will deal with home health needs.  Also, the Study Committee as a whole will review what other states have done on this issue.  It will also meet with the Board of Regents, technical schools, Department of Community Health, and Department of Human Resources to get their input on addressing the healthcare workforce needs.  Likewise, it will also look at the data and recommendations which have been developed by the Division of Health Planning’s Health Strategies Council on this issue as well.