Gold Dome Report - March 7, 2016
Greetings from the Gold Dome! Today was the 32nd day of the Legislative Session. Qualifying of candidates was a major story at the Capitol as many current elected officials lined up to qualify for their offices again and hopefuls for offices also paid their requisite fees to seek office – many for the first time. Qualifying of candidates ends on March 11 at noon.
The other big news of the day was the early morning meeting held by the Senate Appropriations Committee which voted out its new Substitute to HB 751, the FY 2017 Budget. Sen. Jack Hill (R-Reidsville) presented the Senate's version of the legislation. A few highlights of the Senate Budget changes are:
- Department of Behavioral Health and Developmental Disabilities (a total budget of more than $1.2 billion)
- Within Adult Addictive Disease Services, the Senate added $357,990 for funding a pilot of one-time funds for the Highland Rivers Health CSB pilot program to serve individuals in region one (the House had proposed $750,000 for this)
- In Adult Developmental Disabilities Services, the Senate added $10,000 to fund Rockdale Cares
- The Senate added language in the Adult Mental Health Services program (no moneys) so as to "utilize existing Projects for Assistance in Transition from Homelessness (PATH) funds to increase access to supportive housing"
- Department of Community Health (the State's Medicaid program where the Department will receive a total of more than $14.35 billion in funding)
- Health Care Access and Improvement program
- The Senate eliminated a funding reduction made by the House of $500,000 for charity clinics
- The Senate agreed to add $500,000 for one-time funds for two FQHC start-up grants in Jackson and Jenkins Counties
- The Senate agreed to an addition of $250,000 for contracts services for medically fragile children who do not qualify for Katie Beckett TEFRA/Deeming waiver (Champions for Children)
- It added $42,000 for one-time funds for the purchase of three telemedicine equipment devices to support middle Georgia EMS services
- It added $25,000 to increase funding for the Southwest Georgia Cancer Coalition to assist with access to quality cancer care and treatment in southwest Georgia
- Medicaid: Aged, Blind and Disabled program
- The Senate proposed only $20.7 million in funding to cover expenses related to higher pharmacy costs of Hepatitis C drugs and cystic fibrosis drugs (this is down from what the Governor and House had proposed of more than $26 million)
- The Senate agreed to the House number on the reduction of funding on an adjustment for growth in Medicaid based on projected need, cutting that funding by $31.3 million
- The Senate also agreed with the House on the slightly more than $8 million added to reflect a projected increase in the Medicare Part D Clawback
- The Senate agreed to the $4.1 million reduction proposed by the House reflecting changes in rate calculations for nursing facility operators
- The Senate agreed to the House addition of $11.3 million in funding to provide for a three percent inflation adjustment on the 2012 nursing home cost reports
- The Senate agreed with the House addition of $3.7 million for funding ICWP rates to match the CCSP and SOURCE rates
- The Senate agreed to the House addition of $399,670 so as to increase reimbursement rates for Adult Day Health Centers by five percent providing parity with other home and community-based service providers
- The Senate proposed $2 million rather than $1.3 million as a rate increase for occupational therapy and physical therapy providers in the Medicaid CIS program
- The Senate added $95,041 for a three percent rate increase in ventilator reimbursement rates
- Health Care Access and Improvement program
- Department of Education (total funding is proposed at $11.022 billion)
- In the Agricultural Education program, the Senate added $170,000 for increasing funds for Extended Day and also proposed a $35,000 increase for a teacher to assist eligible students attending FCCLA camps
- In the Central Office program, the Senate added $35,000 for the American Association of Adapted Sports Program
- In the Non-QBE Formula Grants program, the Senate agreed with the House on funding with an increase in funds of $93,411 for merit-based pay adjustments and employee recruitment and retention initiatives effective July 1, 2015 and an increase of $528,121 for Residential Treatment Facilities based on attendance
- In the Nutrition program, the Senate agreed with the House on a three percent salary adjustment for lunchroom workers effective July 1, 2016
- In the QBE program
- The Senate added slightly more than $8 million as an increase in funds for State Commission Charter School Supplement (the Governor and House had proposed $10.5 million)
- The Senate agreed with the House on language, rather than an increase in funds for Special Needs Scholarship as proposed by the Governor of $2.6 million – "realize savings from program attrition in the Special Needs Scholarship to fund additional growth"
- The Senate agreed to the House additions of $912,932 for a three percent salary adjustment for school nurses effective July 1, 2016 and to the three percent salary adjustment for school bus drivers in the amount of $2.5 million
- Department of Human Services (total funding of $1.77 billion)
- In Child Support Services, the Senate agreed with the House to increase funds for 10 parent accountability court coordinator positions
- In Child Welfare Services, the Senate proposed to increase funding for CASAs by $750,000 (the House had proposed $500,000) and the Senate also added $1.5 million to increase funds for DFCS Special Assistant Attorneys General for a $5 per hour increase
- In Elder Community Living Services, the Senate proposed $1 million to transition 167 seniors from nursing homes into community settings (the House had proposed $750,000 to move 125 seniors)
- In Elder Support Services, the Senate added $500,000 for increasing funding on Meals on Wheels and senior center nutrition programs (the House proposed $250,000)
- In the Out of Home Care program, the Senate agreed to the House proposed increase in funds for a 1.5 percent provider rate increase for Child Caring Institutions, Child Placing Agencies, foster parents and relatives – this is an addition of more than $4.25 million
- In the Vocational Rehabilitation Agency: Vocational Rehabilitation Program, the Senate added $40,000 to increase funding for Speech, Hearing and Rehabilitation Enterprises of Coastal Georgia (SHARE)
- Department of Public Health (total funding of more than $671.9 million)
- In Adolescent and Adult Health Promotion, the Senate added $2 million (rather than the House addition of $1 million) for increased funds for the Positive Alternatives for Pregnancy and Parenting Grant program and the Senate added $100,000 for an increase of funds for the Biomedical Prevention Clinic and the Senate proposed a reduction of $50,000 to the one-time funds for Georgiacancerinfo.org website (Georgia CORE) (rather than the initial reduction of $75,000 by the Governor which was later restored by the House)
- In the Departmental Administration program, the Senate agreed to the House increase for funding for telehealth maintenance and infrastructure of $122,196
- In Epidemiology, the Senate eliminated the proposed funding for the Grady Georgia Poison Center of $100,000 and the funding for a telephone-based stroke support program for pre-hospital providers in the amount of $100,000
- In the Infant and Child Essential Health Treatment Services program, the Senate eliminated the proposed funding for Medical College of Georgia's Sickle Cell Center in the amount of $117,178
- Within Infectious Disease Control, the Senate proposed $36,442 as an increase in funding for an additional salary increase for registered nurses to address recruitment and retention issues in the highest turnover job classes (the House and Governor had only added $15,161)
- In the Public Health Formula Grants to Counties program, the Senate agreed to the House amount of $1.38 million to increase funds for the sixth year phase-in of the new grant-in-aid formula to hold harmless all counties (the governor had proposed more than $2.1 million); the Senate also added $4.3 million (rather than the House and Governor amounts of $1.79 million) to increase funding for an additional salary increase for registered nurses to address recruitment and retention issues in the highest turnover job classes; the Senate proposed $618,167 to increase funding to provide for an additional salary increase for Licensed Practical Nurses to address recruitment and retention issues in the highest turnover job classes
Hemophilia of Georgia was among the various groups in the halls celebrating a "day at the Capitol" with its staff and volunteers to raise awareness of hemophilia and other bleeding disorders.
The House Rules Calendar consisted of one piece of legislation. Thus, it made for a very short morning after representatives took their time to do morning orders.
SB 283 was moved swiftly through the House by Rep. Bruce Williamson (R-Monroe) with a vote of 162-1. The bill now moves to the Governor's desk as no changes were made in the House. This legislation addresses "multibank pooling of depositories for the acceptance of deposits of public funds from public bodies" in Chapter 8 of Title 45.
The Senate did not have a Rules Calendar.
HR 1592, by Rep. Valerie Clark (R-Lawrenceville), seeks to create the House Study Committee on Child Care Assistance. It will look at families who seek to find affordable child care.
HR 1605, by Rep. Chuck Martin (R-Alpharetta), proposes to create the House Study Committee on Regional Transit Solutions. It will in part look at necessary fundamental reforms which may be required to "ensure the establishment of a comprehensive region-wide system."
House Education Sub-Committee on Academic Achievement and Curriculum
The Subcommittee considered four bills today. The first was SB 329, by Chairman Lindsey Tippins (R-Marietta), relating to dual credit coursework and receipt of a high school diploma when a student completes coursework at a postsecondary institution. This bill received a do pass recommendation and now moves to the Full House Education Committee. Sen. Tippins explained that this legislation "tweaks" SB 2 which was passed in 2015. Since last year, the Lt. Governor and others have worked with the Technical College System, Georgia Student Finance and Central Education Center in Macon on trying to fully implement SB 2. This legislation allows some flexibility on the current requirement for "rigorous" coursework to receive a diploma and the requirement of a student to have at least two technical college certificates of credit programs. The goal is to assure that the student is not prevented from being HOPE scholarship eligible. It also is to address industry needs to have an industrial mechanical certification (which does not currently exist).
HB 1078, by Rep. Margaret Kaiser (D-Atlanta), was heard next. This bill proposes to raise the age of mandatory education to 17, but was actually presented by a couple of students to the committee. Rep. Kaiser indicated that the bill was originally brought to her by the Fulton County Youth Commission. The bill only received a hearing in the Subcommittee; no vote was taken.
SB 348 was also by Chairman Tippins and relates to career academies. Essentially the law currently allows that a college and career academy has flexibility ONLY if it is a charter school. This will permit those entities to obtain flexibility by either being a charter system or have a strategic waiver contract. It also expands the definition of a governing body. Again, Sen. Tippins and the Lt. Governor have worked with the Department of Education and the Technical College System on this legislation. It also permits those facilities to have "bond eligibility." The Subcommittee gave SB 348 a do-pass recommendation.
SB 355 was presented by Sen. Ligon, who also authored the legislation. This is known as the "Student/Teacher Protection Act" and aims to reduce the emphasis placed on student standardized testing. The bill attempts to give students and parents the option to have tests available in alternative formats – in particular so that students may be offered a pencil and paper test. It also addresses the 'sit and stare' policies in schools so that students, who opt out of a test, do not have to remain in the room while the rest of the class completes the test. Parents of a child with a serious health condition may also opt out of testing; it also addresses having a physician or licensed therapist provide such authorization. The legislation also permits a make up of a test and an appeals process. If a school's rating is affected by opt outs of tests, then there is a process so that the school may indicate that the testing was a part of federal law requirements and what the school's rating would have been if such testing were not required. Sen. Ligon indicated that he had worked with the Department of Education on this legislation. Rep. Mike Dudgeon (R-Johns Creek) asked some questions relating to the federal guidelines and penalties associated with such. Rep. Tom Dickson (R-Cohutta) also asked some questions around the "positive learning opportunity" and potential costs to the local system if it was to meet such mandate in the legislation. SB 355 was then held in Subcommittee so that more changes could be made on the language.
Senate Insurance and Labor Committee
SR 1043 was passed relatively quickly. It creates the Senate Study Committee on the Expansion of the Autism Insurance Mandate to ERISA Plans by Sen. Jeff Mullis (R-Chickamauga).
HB 882 was presented by Rep. Darlene Taylor (R-Thomasville) and Sen. Judson Hill (R-Marietta). This legislation seeks to address capital funds required by insurance companies. It repeals certain deposit requirements for foreign and alien insurers and authorizes the use of physician agreements in Georgia. Language was added by Sen. Hill addressing the permission of "concierge medicine" (which would not be considered as an insurance product and subject to regulation by the Department of Insurance). This was essentially the language from SB 265. MD2 a "concierge" group spoke out against the proposed "cap" in the amendment which had been proposed by Sen. Hill. That entity wishes to allow patients to have access to physicians in other areas – especially if the patients travel. MD2 was represented by lobbyist Skin Edge. Sen. Bethel (chairman of the Committee) indicated that he was willing to allow the Committee to consider this Substitute but wished to hold HB 882 in its new form until the Committee met on Wednesday.
HB 883, also by Rep. Darlene Taylor (R-Thomasville), proposes in Chapter 37 of Title 33 to allow the Insurance Commissioner the ability to transfer title and possession of all special deposits under his or her control to a domiciliary liquidator (if the Commissioner does not file a petition in superior court) and to repeal reciprocity provisions to rehabilitation and liquidation of insurers. This legislation was requested by the Department of Insurance. Sen. David Shafer (R-Duluth) moved to do pass this legislation and the motion carried.
Rep. Taylor then presented her third bill to the Committee, HB 884, another piece of legislation requested by the Department of Insurance. Rep. Taylor explained that this legislation would keep Georgia compliant with the NAIC concerning insurers' risk-based capital levels in O.C.G.A. § 33-56-3. It includes a health organization now in the definition. The Chairman indicated that this legislation would also be held until Wednesday for action.
HB 975, by Rep. Jason Shaw (R-Lakeland), was another piece of legislation requested by the Department of Insurance. It too addressed NAIC model language and in particular principal-based reserves in the standardized valuation laws and reserve requirements in O.C.G.A. § 33-10-13 (permitting to base such on mortality tables). This legislation received a do pass recommendation.
HB 818, also by Rep. Shaw, is an annual update on Georgia's workers' compensation laws in Chapter 9 of Title 34. In part, it is the work of the State Board of Workers' Compensation Advisory Council and steps up benefits under current law. It adds a requirement in O.C.G.A. § 34-9-47(c) that an administrative law judge is to be subject to the Georgia Code of Judicial Conduct. In O.C.G.A. § 34-9-121(a), it requires employers who are subject to the payment of compensation furnish the board with "sufficient information for the board to make an adequate assessment of the employer's workers' compensation exposure and liabilities and shall further provide evidence satisfactory to the board of such employer's financial ability to pay the compensation directly in the amount and manner and when due, as provided for in this chapter." Total disability payments as outlined in O.C.G.A. § 34-9-261 are increased from $550.00 to $575.00 per week. Compensation for temporary partial disability payments are increased in O.C.G.A. § 34-9-262 from $367.00 per week to $383.00 per week. Total compensation payable to surviving spouses as sole dependent at the time of death and where there is no other dependent for one year or less after the death of the employee is increased from $220,000.00 to $230,000.00. Definitions are also changed in O.C.G.A. § 34-9-381, relating to the Self-Insurers Guaranty Trust Fund and clarifications are made in O.C.G.A. § 34-9-382(d) as to who cannot be a member in such fund (a governmental employer authorized by the board to self insure; an employer who elects to group self-insure; captive insurers; an employer who pursuant to a reciprocal agreement or contract of indemnity executed prior to March 8, 1960 created funds for the purpose of satisfying obligations of self-insured employers; or an individual or company who enters into a contract or agreement with an employer under which the employer outsources its workers' compensation risks, responsibilities, obligations or liabilities to such individual company and pursuant to such contract or agreement is required to provide workers' compensation benefits to an injured employee even though no common law master-servant relationship or contract of employment exists between the injured employee and the individual or company providing the benefits). Bobby Potter, an attorney on the Advisory Council, spoke to the legislation and it then moved quickly out with a do pass recommendation.
Senate Health and Human Services Committee
Chairwoman Renee Unterman (R-Buford) and her Committee had a number of bills on their agenda.
HB 34, by Rep. Mike Dudgeon (R-Johns Creek), moved quickly from the Committee which creates a new Chapter 52 in Title 31. It proposes to enact the "Georgia Right to Try," allowing patients greater access to experimental treatments and drugs which have not received full FDA approval. Patients and physicians must sign agreements; there is no requirement in the proposal for an insurer to pay. At least 20 other states have passed similar laws. The American Cancer Society has made this legislation a priority. This legislation moves forward to the Senate Rules Committee.
HB 1085, by Rep. Katie Dempsey (R-Rome), is an "alignment" bill moving the Division of Aging from the Department of Human Services to the Department of Community Health. The State's budget has already reflected the movement of the moneys associated with this Division and will now house the aging waivers under one Department. This bill also received a do pass recommendation.
HB 509, by Rep. Jesse Petrea (R-Savannah), creates the Georgia Palliative Care and Quality of Life Advisory Council in Chapter 7 of Title 31. Again, this legislation is an initiative of the American Cancer Society. This Council would consist of nine members and would have subject matter experts. The Commissioner of the Department of Community Health would make the appointments – this caused the Committee some angst. Sen. Bill Cowsert (R-Athens) indicated that the Commissioner was an appointee himself/herself and most such councils/committees had legislative oversight. Rather than amend the legislation in Committee, the Committee held the legislation so that it might make an amendment which would "track" how other such councils/committees had legislative oversight in the Code and to also require that the General Assembly receive an annual update from this Council. Thus, the legislation was held.
HB 555, by Rep. Joyce Chandler (R-Grayson), amends O.C.G.A. § 15-11-64 and addresses the reporting of data to the Administrative Office of the Courts by juvenile court clerks. It specifically requires that the clerks report the total number of petitions or motions filed, the number in which the court appointed a guardian ad litem, the number in which the court appointed counsel, the number in which the judge issued an order authorizing an abortion without notification to the parents, the number in which the judge denied such an order, and the number of denials from which an appeal was filed and the denials being affirmed or those which resulted in reversals of those denials. All of this information is to remain confidential and no names are to be associated with this data submission. Further, the Administrative Office of the Courts is then to report this information to the Department of Public Health. After six months, the Administrative Office of the Courts is to destroy this information. Rep. Chandler assured the Committee that there was no violation of privacy with this legislation. This legislation had an amendment so that the Clerks are to report the information rather than February 28 of each year but on March 15 of each year (as that is the date when they make other data submissions). This legislation received a do pass recommendation and moves to Senate Rules Committee.
HB 212 by Rep. Tom Weldon (R-Ringgold) addresses pain clinics. It makes changes so that no controlled substance may be prescribed or dispensed at a pain management clinic unless a physician or physician assistant authorized to prescribe such or advanced practice registered nurse who is under a physician protocol allowed to prescribe such drugs is present. There was also language addressing anesthesia and its administration at these clinics. The purpose was to limit the abilities of registered nurse anesthetists to administer anesthesia in the freestanding pain management clinics. This amendment to current law caused the Committee some questions. An amendment was also offered to address such language. The hospitals have been concerned about this legislation to ensure that restrictions on ownership and operations of these clinics would not apply to any which were hospital-owned or operated.
HB 944, by Rep. Sheri Gilligan (R-Cumming), also moved out of the Committee. This legislation addresses pronouncement of deaths, permitting registered nurses to do so when a patient, who is an organ donor, dies in hospice. The changes in the bill are the result of amendments made to Rules and Regulations made by the Department of Community Health and align with actual practices in place in hospices and nursing homes.
HB 887 , by Rep. Chuck Efstration (R-Dacula), was held in the Committee. This legislation was used as a vehicle for SB 3 which did not pass in 2015. HB 887 addresses changes in O.C.G.A. § 15-11-135(e) to require that Division of Family and Children's Services provide a placement preference of a child to an adult who is a relative or fictive kin over a non-related caregiver – provided that such relative or fictive kin has met requirements for the placement and such placement is in the best interest of the child. SB 3 is Sen. Unterman's "Supporting and Strengthening Families Act" allowing for the creation, authorization, procedure, revocation, and termination of a power of attorney from a parent to another person for the temporary delegation of power and authority for the care of a minor child. A new definition for "fictive kinship" is to be added.
HB 962 also passed out of the Committee but it too was a vehicle for SB 3 (as described above). HB 962, by Rep. Stacey Abrams (D-Atlanta), seeks to create the position of "kinship care enforcement administrator" in O.C.G.A. § 49-2-1(c) within the Department of Human Services. This individual is to monitor, facilitate, and ensure compliance with all laws, rules, and regulations of the federal government and State which relate to programs, including but not limited to, any pilot programs, subsidies, or benefits available to kinship caregivers or children in their care.
Our 2016 Georgia Capitol team consists of Stan Jones, Chuck Clay, Helen Sloat, and Logan Fletcher. We will also try our hand at tweeting this year – so follow us! @GDR_Live
The articles published in this newsletter are intended only to provide general information on the subjects covered. The contents should not be construed as legal advice or a legal opinion. Readers should consult with legal counsel to obtain specific legal advice based on particular situations.