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Keeping Current @ the Capitol Week of January 29, 2018

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Keeping Current @ the Capitol:

The Advocacy Bulletin for Healthy Mothers, Healthy Babies Coalition of Georgia

And We’re Back!
After a very short week due to the Martin Luther King Jr. holiday and three consecutive days of State closure, the Georgia General Assembly went back in session on Monday, January 22. Budget hearings for State agencies, including the Department of Community Health, were held on Monday and Tuesday of last week. See below for updates on items active or filed during the current session:

Legislative Calendar 2018
The schedule for the remainder of the legislative session has been set. Crossover day – the day that legislation must move from one chamber to the other in order to be considered in 2018 – will fall on February 28. Sine Die – the last day of session – will fall on March 29. The legislature will be in session Monday-Thursday until crossover day, with the remaining 12 legislative days being broken up through March. The full calendar can be viewed online.

HB 669 – Medicaid Expansion
New House Minority Leader, Representative Bob Trammell (D-Luthersville), introduced a bill that would require Georgia to authorize state dollars to draw down additional federal dollars to expand Medicaid. The one-page bill can be found here.

Leader Trammel and other Democrats held a press conference on Thursday to announce more details of their proposal, emphasizing the support it would lend to rural communities as well as creating and attracting jobs. When asked how the State would fund their portion of the expansion costs, estimated to be between $120-200 million, Rep. Sam Park (D-Lawrenceville) suggested a 50-cent tobacco increase.

Other Medicaid Options
Despite a strong push by Georgia Democrats for increasing healthcare access via expanding Medicaid, announcements this week from the House and Senate sent mixed signals on the subject. Some Senate leaders have indicated that a limited Medicaid waiver focusing on the opioid epidemic, homelessness, mental health issues and possibly a pilot program for some safety-net hospitals may be imminent. There is a Senate press conference scheduled for Monday January 29 at 1 PM at the State Capitol that may reveal further details, including ideas that have emerged from a number of study committees, led by Lt. Governor Casey Cagle and Senate Health and Human Services Chairwoman Renee Unterman (R-Buford). Simultaneously, the Lt. Governor has indicated he believes that any growth in Medicaid should be tethered to work requirements for capable recipients. For his part, the Speaker of the House, Rep. David Ralston (R-Blue Ridge), has announced that the House has little appetite to pursue a waiver in any form this year. It appears that the full expansion sought by Democrats is short on the necessary votes. However, most legislators acknowledge that taking no action could further deepen Georgia’s rural access problem and leave the state poorly positioned to address the opioid epidemic. As such, the proposals that emerge from the aforementioned Senate study committees are likely to draw a lot of attention and consideration.

Maternal Mortality
Citing consistently dismal rates in maternal mortality and considering recommendations from the Georgia OB/Gyn Society , House and Senate leaders have converged on addressing maternal mortality in conjunction with the Department of Public Health. Senate Heath leaders, led by Senator Renee Unterman (R-Buford), have signaled that they intend to direct appropriations towards research-based practices to address maternal mortality. NO UPDATE.

Group Prenatal Care
Group Prenatal Care (also referred to as ‘Centering Pregnancy’) is an evidence-based, patient-centered model of group prenatal care. It works to bring patients out of the exam room and into a group setting, helping to build their community of support. This model has gained traction in Georgia and is poised to receive additional funding and support during the 2018 legislative session. HMHB supports funding additional group prenatal care sites in Georgia and supports efforts led by the March of Dimes to make these access points available across the State. NO UPDATE.

SB 334 – Georgia Board of Nursing
Senator Unterman (R-Buford) has introduced SB 334 which would transfer the Georgia Board of Nursing from the Secretary of State’s office to the Department of Community Health.

SB 351 – Independent Practice Authority for APRNs
This bill, filed by Senator Unterman (R-Buford), would make any advanced practice registered nurse eligible to engage as a licensed independent practitioner if they are primarily employed in a rural county. This would include the ability for APRNs to order computed tomography (CT) scans and to prescribe, procure, administer, dispense, and furnish pharmacological agents, including controlled substances.

Deaths from the Flu Double in Georgia; Hospitalizations Soar
Georgia, like most states, has seen a prolific uptick in incidence, hospitalizations and deaths resulting from the flu. A great article on this uptick can be found in Friday’s Georgia Health News. Flu shots in pregnancy have been associated with a significant reduction in the risk of stillbirth, reduced numbers of preterm and low birthweight babies and significant decreases (81-91%) in the risk of infant influenza hospitalization during the first six months of life. The data shows that if the obstetrical clinician offers the flu shot in the practice, a pregnant woman is five times more likely to get the vaccine than when the clinician does not give such vaccines in-house or discuss the vaccine. Although recommended for pregnant women by the CDC and the American College of Obstetricians and Gynecologists, birth data in Georgia shows that only 15% of women got a flu shot in pregnancy in 2016 while national survey data from the CDC shows 53.6% of women had vaccination coverage when pregnant during the 2016-17 flu season (16.2% vaccinated before pregnancy and 37.4% vaccinated during pregnancy). Currently, most Georgia obstetrical practices do not offer in-house flu shots. The Georgia Medicaid reimbursement rate significantly lags even the Medicare reimbursement rate and does not cover the costs associated with the service. To incentivize obstetrical clinicians to give in-house inoculations to pregnant women, HMHB recommends a higher reimbursement rate for the medical service.

American Lung Association Report – Georgia Gets an “F”
Speaking of a tobacco tax, the American Lung Association released a report this week giving Georgia an “F” in four of five categories for tobacco prevention and control. Smoking, and exposure to second hand smoke, are linked with a range of prenatal and neonatal health conditions that are both expensive and devastating to children’s health. The full ALA report on Georgia, including how we stack up against other states, can be viewed here.

Mental Health/Suicide Prevention Services Lacking in Georgia

A report, released last week by Voices for Georgia’s Children, quantified what many already suspected: The mental health workforce in Georgia is woefully inadequate. Further, this inadequacy is driving some embarrassing statistics for Georgia including:

  • 80,000 students in grades six through 12 report they have seriously considered harming themselves.
  • In 2017, the youngest child on record to have died by suicide was 9 years old.
  • Pediatric mental health providers in the field tend to be significantly underpaid compared to industry standards.

The full report can be read here.

INFANT MORTALITY AWARENESS DAY – FEBRUARY 21, 2018: Healthy Mothers, Healthy Babies Coalition of Georgia, along with Heart of Georgia Healthy Start, Enterprise Community Healthy Start, Atlanta Healthy Start Initiative, Clayton County Healthy Start and March of Dimes Georgia, invites you to join us for a day of awareness raising and advocacy on February 21, 2018. We will be displaying approximately 900 infant onesies to raise awareness around Georgia’s very poor infant mortality ranking and speaking with legislators regarding policies and budget priorities that will move the needle on maternal and infant health in Georgia. We had 962 infant deaths in Georgia during 2016.

REGISTER TO ATTEND