Federal funds, remote work prop up Georgia health agencies amid COVID-19

State health agencies in Georgia are weathering last year’s budget cuts from the COVID-19 pandemic with a boost from the federal government and by working more remotely, several agency heads told state lawmakers Thursday.

An increase of hundreds of millions of dollars in the federal share of Medicaid costs helped the state Department of Community Health (DCH) cover more Medicaid-eligible families and children “than we have ever had before,” said DCH Commissioner Frank Berry.

The number of Medicaid recipients in Georgia spiked by more than 150,000 between March and August of last year, increasing to about 2 million recipients as of September, according to federal Centers for Medicare and Medicaid Services data.

DCH officials managed to save nearly $345 million under a federal policy allowing states to reduce their payment shares for Medicaid through the end of June this year, after which officials expect Georgia’s Medicaid costs to increase by about $201 million in fiscal 2022.

Larger federal spending on Medicaid also saved about $32 million in costs that would have been cut last year from the state Department of Behavioral Health and Developmental Disabilities (DBHDD), which treats more than 200,000 Georgians with mental health and substance abuse issues.

Mental-health caseworkers benefitted from relaxed rules on telehealth that allowed them to keep seeing clients remotely who may have otherwise fallen into crisis situations requiring emergency hospital care, said DBHDD Commissioner Judy Fitzgerald.

“There is no aspect of health and human services that has not been touched by the pandemic,” Fitzgerald said. “Every impact of our delivery service has been dramatically changed very rapidly as a result of [COVID-19].”

Health-focused agencies pitched lean budget proposals Thursday after weathering roughly $2.2 billion in spending cuts last year across state government from the pandemic. State lawmakers are assessing budgets through June 2022 that would avoid the 10% cuts approved during last year’s legislative session.

Federal funds also propped up the state Department of Human Services (DHS) with $30 million for home-delivered meals and caregiver support for the thousands of elderly Georgians the agency serves, said DHS Commissioner Robyn Crittenden. Her agency is seeking an extra $1 million for more elder-abuse caseworkers.

Meanwhile, the state Division of Family and Children Services (DFCS) is set for about $14 million in savings after adopting out foster kids to homes last year. DFCS Director Tom Rawlings told lawmakers the agency has reduced the number of foster children in its care from 15,000 to 11,200 since 2018 but could move faster if placement hearings were not suspended due to the pandemic.

“We’ve got to have those hearings to move those children into successful permanency,” Rawlings said.

With the budget picture clearer, agencies like Berry’s DCH are preparing to spend millions of dollars on implementing Gov. Brian Kemp’s health insurance changes starting in July. DCH officials are also grappling with a nearly $700-million deficit projected in the next few years for the state health benefit plan, which covers around 665,000 government and school employees in Georgia.

The amended fiscal 2021 and fiscal 2022 budgets for the agencies are poised for approval in the coming weeks as the General Assembly continues the 2021 legislative session.

Fund dedications for tire clean up, other uses up for vote in Georgia

State lawmakers are pushing for Georgia voters to pass a ballot measure that would in set in stone how certain taxpayer dollars can be used for dedicated funds like cleaning up tire dumps.

Georgians will decide in the November election whether to approve a constitutional amendment that requires state funds reserved for specific purposes to be spent on those purposes, rather than funnel back into the all-purpose general fund.

The amendment’s approval would be a boon for Georgia environmentalists and local government officials who have watched large chunks of state funding meant to clean up discarded tires and remediate landfills steer away from those uses in recent uses and redirect into the general fund.

“Passage [of the bill] is going to be the answer to a conundrum that has been around for decades,” said Rep. Debbie Buckner, D-Junction City.

“Georgia law has never allowed for the dedication of funds to be collected by the state and to be used by the state agencies without a constitutional amendment. So therefore, it was left up to the goodwill of the General Assembly to try to make it happen.”

The amendment proposal, sponsored by the late Rep. Jay Powell, R-Camilla, would automatically require dedicated funds to be used for specific purposes without need for the General Assembly to pass additional legislation defining that purposes, as has been the practice in recent years.

State lawmakers aired their thoughts on the proposal in a meeting Wednesday of the Georgia Senate Interstate Cooperation Committee.

Several environment advocates and local government leaders highlighted how dollars have been pulled from a solid-waste trust fund meant to clean up tire dumps and other blight, and instead put toward broader uses as Georgia struggled to rebound from the economic recession more than a decade ago.

Roughly 40% of the $366 million raised for the dedicated fund since its creation in 1990 has not actually gone into the fund, said Fairburn City Councilwoman Hattie Portis-Jones.

“What we’d like to see is every dollar collected be used for its intended purpose,” Portis-Jones said at Wednesday’s meeting.

There would still be some caveats for spending funds if the amendment passes. Dedicated funds could not exceed 1% of total state revenues from the previous year. And in a financial emergency, the governor and legislature would have the authority to temporarily suspend the dedication of funds.

Gov. Brian Kemp signed the trust-fund ballot measure after the lawmakers passed it in March. It requires final voter approval in the Nov. 3 general election before taking effect.

Georgia Democrats tap party chair to replace John Lewis in Congress race

State Sen. Nikema Williams was tapped by Georgia Democratic leaders Monday to run as the party’s nominee to replace Congressman John Lewis in the upcoming Nov. 3 election, following the civil rights icon’s death on Friday.

Lewis’ death at age 80 precipitated a frantic search over the weekend to pick a new nominee to run for his 5th Congressional District seat in November, since the civil rights leader had already won the Democratic primary in June and therefore needed to be replaced.

Williams, who currently chairs the Democratic Party of Georgia, touted her background as an activist and seasoned lawmaker during a party meeting Monday, which resulted in her selection as the nominee for the Atlanta-based congressional seat Lewis held for more than three decades.

She cast herself in the mold of Lewis as a fighter who would push for voting rights and follow up on her work in the Georgia Senate, to which she was elected in 2017. Beyond the state Capitol, she holds executive positions in the National Domestic Workers Alliance.

“I have a long career in activism, advocacy and policy to serve as a strong fighter for our communities and values nationally,” said Williams, D-Atlanta. “I believe my experiences, accomplishments and proven record of fighting for my constituents and party values make me the ideal candidate for this seat.”

Williams will need to drop her re-election bid for her Atlanta-based 39th state Senate District seat in order to run for Congress. The Senate district, like Lewis’ congressional district, leans heavily Democratic.

Lewis, a prominent civil rights leader who was beaten by police in Selma, Ala., during a protest march in 1965, served 33 years in Congress before his death following a seven-month battle with pancreatic cancer.

Lewis was poised to defend his seat for an 18th consecutive term against Republican challenger Angela Stanton King. But his death sparked a complicated and quick-moving process for state Democrats to pick his replacement to square off against King rather than let Republicans claim the reliably blue district.

Under state law, Democratic leaders had until Monday at 4:30 p.m. to hand in their replacement nominee to the Secretary of State’s office, prompting a hectic round of weekend inter-party wrangling to winnow down a list of 131 people who applied for a chance to be the nominee.

By Monday, those applicants were trimmed to five finalists: state Rep. Park Cannon, D-Atlanta; Atlanta City Councilman Andre Dickens; former Morehouse College President Robert Franklin; Georgia NAACP President James Woodall; and Williams.

Party leaders picked Williams by a near-unanimous vote during a meeting that ran close to the deadline. Before voting, they took turns to honor Lewis, praise the five finalists and slam the state law that forced them to submit a replacement nominee within one business day.

Speaking at Monday’s party meeting, Williams recalled growing up just across the Georgia line in Smiths Station, Ala., where she hitched rides on her grandfather’s truck to help hand out slate cards for voters in her neighborhood on Election Day.

She reminisced over reading about her great-aunt, Autherine Lucy, who was the first Black student to attend the University of Alabama in 1956. Williams noted joining a union while in college, teaching in Fulton County schools and working for Planned Parenthood Southeast as public-policy executive.

Williams also described being arrested during protests after the controversial 2018 Georgia gubernatorial election, framing the event as an example of the fighting spirit similar to that which Lewis showed in his life.

“He showed me the value of putting myself, sometimes physically, in between the dangerous policies that the most vulnerable communities are hurt by,” Williams said. “His leadership and fighting spirit are needed now more than ever in this country.”

Governor favors in-person classes for Georgia schools

Gov. Brian Kemp said Friday he favors resuming in-person classes for Georgia students instead of remote learning methods ahead of the upcoming school year amid the COVID-19 pandemic.

The governor also doubled down on his opposition to mask mandates in Georgia even as he urged people to wear them for the next several weeks to help curb a recent increase in positive COVID-19 cases and hospitalizations.

At a news conference Friday morning, Kemp and other state officials highlighted new guidance for schools on how to reopen classrooms in the fall and respond when a student or teacher is infected.

The governor said he understands fears over returning to school with the virus still spreading but that students risk losing valuable learning and social growth opportunities by remaining at home after in-person classes were canceled statewide in March and students switched to online studies.

“I am a believer that kids need to be in the classroom,” Kemp said. “And we’re working with the schools on doing that.”

Kemp’s comments came shortly after he and Georgia Attorney General Chris Carr filed suit to block a mask mandate in Atlanta as well as moves by Mayor Keisha Lance Bottoms to reimpose certain stay-at-home and business closures lifted in May.

Reiterating his position, Kemp called city and county mask mandates “unenforceable” and pressed Georgians – especially young people – to “do the right thing” by voluntarily wearing masks, social distancing, washing hands and following statewide business restrictions.

“We can argue about a mandate for masks or not,” Kemp said. “But all the people arguing agree that we should wear a mask.”

On Friday, Kemp and other officials noted they talked with top national health experts this week about how to safely reopen schools in the coming weeks.

The state Department of Education has issued guidelines and recommendations aimed at helping local school districts decide how to hold classes in the fall via a mix of regular in-person classes and online instruction options.

State School Superintendent Richard Woods agreed students would be better served returning to school as normal but that his focus is on student, teacher and staff safety.

“The first day of school will be the first day of school,” Woods said Friday. “You can expect hiccups. You can expect challenges. But I guarantee your kids will be safe, your teachers will be safe and we will learn.”

School and health officials are also focusing on how to avoid the need to shut down a school in the event a student tests positive or there is a minor outbreak, said Dr. Kathleen Toomey, the state’s public health commissioner.

She said epidemiologists working one-on-one with schools would help guide that decision, factoring in a classroom’s size and the extent of a person’s exposure to others in the school.

“We will make those decisions based on the situations in every school,” Toomey said. “Every situation will be different.”

Already, around 2 million masks and 3,000 infrared thermometers have been shipped to schools across Georgia, said the state’s emergency management director, Homer Bryson.

The state also plans to send schools another batch of safety and sanitizing gear including 1.5 million youth-size cloth masks, 1 million disposable masks, thousands of hand sanitizing stations, gallons of gel and wipes, and 100,000 clear masks for deaf and hard-of-hearing students and teachers, Bryson said.

Per the guidelines and governor’s orders, students would not be required to wear masks but they would be “strongly recommended” to do so, particularly when in close quarters.

Kemp sues Atlanta to block mask mandate, reopening rollback

Gov. Brian Kemp speaks at Wellstar Kennestone Hospital in Marietta shortly before releasing a lawsuit against Atlanta’s COVID-19 mask mandate on July 16, 2020. (Photo by Beau Evans)

Gov. Brian Kemp is suing Atlanta to block the city’s enforcement of a mask mandate and resumed stay-at-home guidelines amid the ongoing COVID-19 pandemic, according to court documents filed Thursday.

The lawsuit, filed by Kemp and Georgia Attorney General Chris Carr, seek to have a Fulton County Superior Court judge declare unlawful a citywide masking requirement imposed by Atlanta Mayor Keisha Lance Bottoms last week.

It marks an intense ratcheting up of the dispute between Kemp, who has insisted on leaving masks as recommended but voluntary measures, and several Georgia mayors like Bottoms, who want local control over mandatory measures to help curb the virus’ spread.

The governor’s office has frequently stressed his executive orders – which make mask-wearing “strongly encouraged” but not required – override any city or county actions that go beyond the state’s COVID-19 rules.

Along with blocking the city’s mask orders, Kemp and Carr’s lawsuit asks the judge to prohibit Bottoms and the Atlanta City Council from approving any local orders that might be considered more restrictive than the governor’s.

That would include resuming limits on public gatherings to 10 persons and recent steps taken to reimpose a shelter-at-home order for city residents, according to the suit.

Additionally, the suit seeks to bar Bottoms from “issuing press releases, or making statements to the press, that she has the authority to impose more or less restrictive measures than are ordered” by the governor.

Bottoms, who tested positive for COVID-19 last week, cast the governor’s priorities as misplaced in light of the impacts of the virus, which has sickened hundreds of thousands of people in Georgia and killed thousands more.

“A better use of taxpayer money would be to expand testing and contact tracing,” Bottoms said Thursday. “If being sued by the State is what it takes to save lives in Atlanta, then we will see them in court.”

Kemp lashed out at Bottoms in a statement sent along with the suit, accusing the mayor of “reckless actions” and vowing to “put people over pandemic politics.”

“This lawsuit is on behalf of the Atlanta business owners and their hardworking employees who are struggling to survive during these difficult times,” Kemp said. “These men and women are doing their very best to put food on the table for their families while local elected officials shutter businesses and undermine economic growth.”

Kemp is scheduled to hold a news conference on COVID-19 early Friday morning.

Bottoms and other local officials from Savannah, Augusta, Athens and elsewhere have pleaded with the governor in recent weeks to allow them to enforce mask mandates in their communities if he will not impose one for the state.

Many public health experts have also urged Georgians to wear masks in public as positive COVID-19 cases and hospitalizations continue increasing in the weeks following Memorial Day weekend in late May.

After weeks of testy back-and-forth, the battle between Kemp and Bottoms kicked up a notch Wednesday when the governor issued new orders explicitly preventing local governments from imposing mandates for masks, face shields and other kinds of virus-protecting gear.

Bottoms and Savannah Mayor Van Johnson rejected the move. Johnson, who was first to impose a citywide mask mandate on July 1, wrote on Twitter late Wednesday night that “Governor Kemp does not give a damn about us.”

“In Savannah, we will continue to keep the faith and follow the science,” Johnson said. “Masks will continue to be available!”

As of Thursday afternoon, more than 131,000 people in Georgia had tested positive for COVID-19, the disease caused by the novel strain of coronavirus that sparked a global pandemic. It had killed 3,104 Georgians.

This story has been updated to revise the headline and include an additional comment from Mayor Bottoms.

Kemp signs legislation on surprise hospital bills, Medicaid for mothers

Gov. Brian Kemp discusses health-care legislation he signed at Wellstar Kennestone Hospital in Marietta on July 16, 2020. (Photo by Beau Evans)

Gov. Brian Kemp signed a spate of bills Thursday that passed out of the 2020 legislative session on curbing surprise medical charges, temporarily licensing out-of-state dentists and extending Medicaid coverage for new mothers.

At a signing ceremony Thursday, Kemp highlighted the importance of signing health-care focused legislation as the COVID-19 pandemic continues to hit Georgia. More than 131,000 people had tested positive for COVID-19 in Georgia as of Thursday afternoon, including 3,104 people who have died.

“This is certainly an important moment and a historic step forward in my opinion for Georgia when it comes to health care,” Kemp said during the ceremony at Wellstar Kennestone Hospital in Marietta. ”Frankly, it couldn’t come at a better time as our state and our country face the greatest public health challenge that we’ve seen.”

State lawmakers passed numerous bills in the coronavirus-interrupted session that wrapped up last month. Many still await Kemp’s signature including COVID-19 liability protections for businesses and hospitals, home-delivery alcohol services and an excise tax on vaping products.

House Bill 888, by Rep. Lee Hawkins, R-Gainesville, aims to reduce the chances for patients to receive unexpectedly high hospital bills by requiring health insurers and health-care providers to settle cost disputes arising from emergency medical procedures performed by out-of-network providers.

Its companion legislation, House Bill 789, creates a rating system for hospitals based on how many medical specialty groups like anesthesiologists and radiologists are contracted. The bill’s sponsor, Rep. Mark Newton, R-Augusta, said the intent is to promote “truth-in-advertising” that can help curb surprise billing practices.

Another health-care piece of legislation, House Bill 1114 authorizes the state to apply for a federal waiver extending Medicaid coverage to new mothers for up to six months after birth instead of the current limit of two months. Sponsored by Rep. Sharon Cooper, R-Marietta, the bill also extends Medicaid coverage for breast-feeding and lactation care.

House Bill 521, by Rep. Houston Gaines, R-Athens, allows dentists licensed outside the state to temporarily practice dentistry in Georgia if they are serving low-income patients at clinics or charitable events. The temporary licenses will be valid for five days.

Other legislation Kemp signed Thursday includes:

  • House Bill 932 (by Gaines): Allows podiatrists in Georgia to organize professional corporations with other doctors and revises certification rules for podiatrists performing foot amputations.
  • House Bill 578 (by Rep. Katie Dempsey, R-Rome): Permits the state Department of Human Services to conduct criminal background checks on volunteers and interns.
  • Senate Bill 28 (by Sen. Lester Jackson, D-Savannah): Prohibits insurance copayments for health benefits plans from being set in a way that could “unfairly deny health-care services.”
  • Senate Bill 395 (by Rep. Ben Watson, R-Savannah): Sets terms for investments in mutual, trust and retirement funds, and revises terms on reserving proceeds from the sale of hospitals for indigent care.