ATLANTA – The state should require hospitals planning to close or eliminate core medical services to give 180 days written notice, the head of a statewide consumer advocacy group said Tuesday.
That six months lead time should involve a review that would include a third-party assessment and a public hearing, Liz Coyle, executive director of Georgia Watch, told members of a Georgia House study committee meeting in Augusta.
Wellstar Health System provided only 30 days notice last year when it closed the Atlanta Medical Center, Coyle said.
“It happened so fast, and the community is still devastated,” she said. “We want this to be a much more public process.”
The study committee is looking for ways to modernize Georgia’s Certificate of Need (CON) law governing capital investments in the construction of new hospitals or the addition of new health-care services. The law requires project applicants to demonstrate a need for the new hospital or service in a given community.
Coyle said 180 days is how long it typically takes applicants to go through the CON review process, so it makes sense to require that much lead time before a hospital can shut its doors.
While the Georgia Department of Community Health is currently considering a 180-day notice requirement, she said she would like to see the General Assembly codify it into state law.
Hospital closures aren’t just affecting the Atlanta region. Jimmy Lewis, CEO of HomeTown Health LLC, told the committee 15 rural hospitals in Georgia have closed in the last 20 years.
“When we lose a hospital, we lose an economic generator,” Lewis said. “When these close, that community goes away.”
Coyle said requiring hospitals to give 180 days notice of an impending closure would give community leaders time to identify and obtain sources of funding to keep the facility open. She cited a poll Georgia Watch conducted in April, working with the University of Georgia, that found 82.9% of respondents support requiring a six-month review of proposed hospital closures.
Coyle suggested the lack of transparency in the current closure process may be contributing to the number of closures.
But Rep. Mark Newton, R-Augusta, an emergency room physician, said requiring that much public notice of a closure could aggravate the financial problems a hospital is having by prompting vendors to cancel contracts and employees to leave for more secure jobs.
Coyle also recommended other ways of increasing transparency besides the 180-day notice of a hospital closure, including legislation requiring hospital administrators to file quarterly financial reports that would be accessible to the public.
But Rep. Sharon Cooper, R-Marietta, who chairs the House Public Health Committee, said such a mandate could be overly burdensome for small hospitals.
“The cost of people to do this is beyond the resources of rural hospitals,” she said.
Coyle said the resource problem could be solved by getting state government accountants to compile the required reports.
The study committee on CON modernization will hold its next meeting in Albany before wrapping up its work with a final meeting in Atlanta. The panel is expected to make recommendations in time for the 2024 General Assembly session starting in January.
Sen. Carden Summers, R-Cordele, listens to arguments for and against the bill he is sponsoring that would ban some gender-affirming care for transgender youths. (Photo credit: Rebecca Grapevine)
ATLANTA – The Republican-controlled state House of Representatives’ Public Health Committee approved a controversial bill Tuesday that would ban some gender-affirming care for transgender Georgia youths.
The bill would prohibit hospitals and doctors from providing hormone-replacement therapy or gender-affirming surgeries to transgender minors. However, It would allow some gender-related treatment for certain medical conditions and let transgender youths take puberty blockers.
The panel also approved an amendment to allow doctors to be held civilly and criminally liable for providing hormone-replacement therapy or gender-affirming surgeries to Georgians under 18 before approving the bill as amended in a 12-10 vote along party lines.
House Democrats argued the bill’s ban on gender-affirming care for under-18s would put Georgia law at odds with the recommendations of several major medical societies, including the American Academy of Pediatrics. The Georgia chapter of the group also opposes the bill.
“Why do you think the judgment of the Georgia state legislature should supersede what the American Academy of Pediatrics has determined to be best practices in caring for gender diverse children?” Rep. Michelle Au, D-Johns Creek, a physician, asked Sen. Carden Summers, R-Cordele, the bill’s sponsor.
“I can’t speak to that,” Summers responded. “Instead of having a surgery…before the age of 18 years old…I want to put a pause there. I don’t think any child should have irreversible surgery. … Our job here is to protect children.”
But others in the standing-room-only hearing pushed back against the claim the bill would protect children, noting that transgender youths are far more likely to think about and attempt suicide than other children.
“These life-saving treatments [are] the reason I am able to speak to you today,” 18-year-old Leonardo Hinnant told the committee, explaining that he began hormone-replacement therapy at age 13 and had a double mastectomy a few years later. “The reality of it is, if this bill passes, transgender kids will die.”
“These decisions are not made with haste, especially for minors,” Hinnant added, explaining that he underwent months of counseling and many doctors’ appointments before finally undergoing surgery.
“This decision is not easy,” committee Chairwoman Sharon Cooper, R-Marietta, said in response to Hinnant’s testimony. “I only wish there was an accompanying bill – if this one should pass – that says that we will always also stand behind transgender people and transgender children and not let you be discriminated against.”
“The fact that the legislature is second guessing well-established standards of care is troubling,” Jeff Graham, executive director of LGBTQ advocacy group Georgia Equality, told Capitol Beat after the standing-room-only hearing.
“All medical professionals and all parents should be extremely concerned about the message this sends — that the legislature knows better than parents working with medical providers to make decisions regarding their children.”
Some on the right – such as Frontline Policy Action, a Christian advocacy group — are opposed to the bill as well, arguing that it does not go far enough and includes too many exceptions.
The bill next moves to the House Rules Committee, where lawmakers will consider whether it should go before the full House for a floor vote. If passed in the House, the state Senate would then vote on the bill again prior to the last day of the legislative session, March 29.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
Rep. Sharon Cooper, R-Marietta, chairs the state House of Representative’s public health committee, which unanimously approved a new mental health bill Tuesday. Cooper was joined by Kim Jones, executive director of the National Alliance on Mental Illness-Georgia (left), and Jeff Breedlove, chief of policy and communications for the Georgia Council for Recovery (right), just after the committee approved the bill.(Photo credit: Rebecca Grapevine)
ATLANTA – The second chapter in Georgia’s mental health reform effort Tuesday gained the unanimous approval of the state House of Representatives’ Public Health Committee.
Cosponsored by Reps. Todd Jones, R-South Forsyth, and Mary Margaret Oliver, D-Atlanta, the lengthy new bill aims to increase the size of the mental-health workforce in Georgia and make it easier for people who cycle between the streets, emergency rooms and jails to get the help they need.
“What we’ve seen is a commitment by the House in a bipartisan way to continue to save lives by advancing policy to transform the broken system into the system that serves Georgia families,” Jeff Breedlove, chief of policy and communications for the Georgia Council for Recovery, told Capitol Beat just after the committee vote.
To address Georgia’s workforce shortage, the bill would create a loan repayment program for people who are already in practice providing mental-health services and agree to provide care in underserved communities. That would build on last year’s measure that created a similar loan forgiveness program for students. This year’s proposal focuses on encouraging those who are already in practice to serve those in need as soon as possible.
The bill also would create a task force to look at what the state can do to streamline mental-health licensing procedures, including creating a way for people who are already licensed in foreign countries to get licenses in Georgia.
It would reform some disciplinary measures for nurses and other professionals facing behavioral health or substance abuse problems to bring them in line with current procedures for doctors.
Rep. Michelle Au, D-Johns Creek, who is a doctor herself, was able to get a last-minute amendment that would require a workforce study commission to examine cultural competence and language so as to better understand how the state can meet the needs of Georgia’s diverse population.
“That’s a pro-business amendment,” Breedlove said. “I think it’s so important as Georgia touts itself as the number one state to do business that we pay attention to the changing demographics of the state.”
The bill would also commission a “bed study” that would examine how the state’s inpatient psychiatric treatment beds are allocated. Oliver has expressed concern that children from out of state are being treated in Georgia’s facilities in part because they’re less expensive.
“Do we not have enough beds or are we are not using them correctly?” Oliver said.
To address the problem of “familiar faces” – people who require many health-care, criminal-justice and homeless-related resources due to severe mental illnesses – the bill requires the state Department of Community Affairs to undertake a study about how the Peach State could provide better housing for people with serious mental illness.
Two “peer support specialists” would be added to the state’s Behavioral Health Reform and Innovation Commission, which is tasked with studying Georgia’s mental-health system and recommending policy reforms. Peer support specialists are people who have lived through mental-health or substance-abuse challenges and use that experience, coupled with specialized training, to help others with similar problems.
“It’s important for peers to be on there because they are the ones … who have been through this system and know what works and what doesn’t work,” said Kim Jones, executive director of the National Alliance on Mental Illness-Georgia.
The bill now moves to the full state House of Representatives for consideration, where it must receive approval by next Monday’s “Crossover Day” deadline.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
Georgia Rep. Richard Smith is returning as chairman of the House Rules Committee.
ATLANTA – The Georgia House Committee on Assignments filled out its list of committee leadership appointments Tuesday.
Many key committees will be headed by returning chairs. The powerful Rules Committee, which controls the flow of legislation on the House floor, will continue to be led by Rep. Richard Smith, R-Columbus.
Rep. Robert Dickey, R-Musella, is back as chairman of the Agriculture & Consumer Affairs Committee. The Transportation Committee will continue to be headed by Rep. Rick Jasperse, R-Jasper.
Rep. Chuck Martin, R-Alpharetta, returns as chairman of the House Higher Education Committee. Longtime Natural Resource & Environment Committee chair Rep. Lynn Smith, R-Newnan, returns in that capacity.
Rep. Shaw Blackmon, R-Bonaire, once again will head the House Ways and Means Committee, which handles tax legislation.
Some major committees will get new chairs. Rep. Chris Erwin, R-Homer, will be the new chairman of the House Education Committee, succeeding Rep. Matt Dubnik, R-Gainesville. Dubnik will chair the House Appropriations Committee’s Education Subcommittee.
The House Judiciary Committee (Non-civil) will be headed by Rep. Tyler Paul Smith, R-Bremen. Smith takes over for Rep. Chuck Efstration, R-Dacula, the new House majority leader.
The new Health Committee chairman is Rep. Lee Hawkins, R-Gainesville. The committee’s former chair, Rep. Sharon Cooper, R-Marietta, is moving over to chair the newly created House Public Health Committee.
The committees will begin holding organizational meetings next week when the House comes back into session following this week’s recess to review Gov. Brian Kemp’s budget recommendations.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
Under the prior law, any person living with HIV who did not disclose positive HIV status prior to a sexual act could face a felony charge punishable by up to 10 years in prison, according to Georgia Equality, an LGBT advocacy group.
The revised law is narrower in scope. Now, Georgia law penalizes only those sexual acts performed by a person living with HIV “with the intent to transmit HIV” when the act “has a significant risk of transmission based on current scientifically supported levels of risk transmission.”
Such incidents could still be punished as felonies, but the maximum punishment has been reduced to five years.
The bill also excludes punishment when a person living with HIV is forced to perform a sexual act against his or her will, as in cases of sexual assault or rape.
State Sen. Chuck Hufstetler, R-Rome, initially sponsored the bill in the Senate. It was strongly supported by Georgia Rep. Sharon Cooper, R-Marietta, the chair of the House Health and Human Services Committee.
The bill passed the Senate with just two “no” votes before clearing the House unanimously.
“The current HIV laws were written in the 1980s,” Hufstetler said Wednesday. “They really didn’t distinguish between HIV and AIDS [and] criminalized hypodermic needles and syringes.
“I’m hoping that laws that align with public health best practices will contribute to better control of individuals that have obtained [HIV] and also a reduced infection rate. As an anesthesia provider in the medical community, I believe it’s my responsibility to correct these things in laws when I become aware of them,” Hufstetler said.
“As a person living with HIV, I’m encouraged that the [Georgia] legislature understands the advances in HIV science,” added Malcolm Reid, coalition co-chair and federal policy chair for People Living with HIV Caucus, in a press release. “Ending the stigma around HIV is a necessity to ending the HIV epidemic.”
The new law will “hopefully will result in fewer convictions,” said Catherine Hanssens, the executive director for the Center for HIV Law and Policy in New York.
“At the same time, the law is still HIV-specific, singling out people living with HIV for uniquely negative treatment in a way that other serious and incurable diseases are not…There is still work to be done,” Hanssens added.
The change to Georgia law reflects advances in HIV treatment, especially the development of drugs that can suppress the amount of virus in the blood, also called the “viral load.”
Drug regimens can effectively suppress the amount of virus in the blood to very low or even undetectable levels, according to the federal Centers for Disease Control (CDC).
“If you have an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex,” according to the CDC website. Most people who follow the appropriate drug treatments can reach an undetectable viral load in just six months, the agency says.
There were 56,466 people living with HIV in Georgia in 2019, according to AIDSVu, an online tracking tool based at Emory University in Atlanta. Of those, about two-thirds, or 33,370, had achieved viral suppression, or very low levels of virus in the blood.
Most Georgia cases were transmitted by sexual contact, but around 7% of cases in Georgia are attributable to injecting drugs, according to AIDSVu data.
The bill also changes Georgia law so that distributing hypodermic needles or syringes is no longer punishable.
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.
