Proposal for multi-year study of state’s health care system adds to debate
By David Pendered
A state Senate committee this afternoon is to take up two bills that offer completely different approaches to restructure the state’s system that oversees the expansion of health facilities, a topic expected to draw such a large crowd that the meeting is scheduled in the Senate’s largest committee room.
The main difference in the two bills is whether lawmakers want to change the state’s health care delivery process in this session, or the next; or to continue to study the process.
The heart of the issue is a certificate issued by the state to confirm that a new or expanded hospital or facility, or major service, is needed. The certificate of need is issued by the state Department of Community Affairs.
Senate Bill 74 prescribes a new approach. Senate Bill 114 calls for further study by a proposed Health Strategies Council. Both measures are on the agenda of the Senate’s Regulated Industries and Utilities Committee.
SB 74 and a companion bill in the House, House Bill 198, resulted from a report presented in December 2018 by the House Rural Development Council. The measure is endorsed by House leadership. The council called for a “revolution” in the state’s health care delivery system.
SB 114 was presented Feb. 19 by Sen. Dean Burke (R-Bainbridge) and was signed by senators including Sen. Larry Walker (R-Perry) and Sen. Renee Untermann (R-Buford). Walker’s district includes a health system that saw its credit rating downgraded last month, Houston Healthcare. Untermann waged a high-profile battle with Senate leadership over her committee appointments.
SB 114 was filed after it became apparent that the initial proposal to revise regulations was dividing the once-monolithic group of hospital systems.
Piedmont Health System, for example, has said it can accommodate a changing regulatory structure. Organizations including the Georgia Hospital Association and Georgia Alliance of Community Hospitals have said they prefer the existing system.
The heart of SB 114 calls for continued review of the matter by a Health Strategies Council that would be:
“[R]esponsible for developing a draft state health plan, developing draft component plans for specific clinical health services, developing and recommending proposed rules, and advising the department.”
The committee is to be comprised of 15 members.
Some members are to be appointed to a term of four years. Once those terms are expired, successors are to be appointed. An annual report is due by Dec 1 of each year. The annual report is not to be released to legislators, but the council is to notify members that the report exists.
Proposed duties of the council include:
- “Review, comment, and make recommendations to the board on components of the state health plan;
- “Review and comment on proposed rules for the administration of this chapter, except emergency rules, as requested by the department;
- “Conduct an ongoing evaluation of Georgia’s existing health care resources for accessibility, including but not limited to financial, geographic, cultural, and administrative accessibility, quality, comprehensiveness, and cost;
- “Study long-term comprehensive approaches to providing health insurance coverage to the population of this state in its entirety; and
- “Perform such other functions as may be specified for the council by the department or its board.”