Gold Dome Report - January 26, 2017
Greetings! Today marked the 8th legislative Day of the 2017 Session. Lawmakers will be in recess until Monday, January 30, 2017. The most significant news is that the House passed the FY 2017 Amended Budget today, moving that document to the Senate for its review. More on the Budget is below.
Governor Deal has received word from the White House that FEMA will provide financial help to the six counties in the southern part of the State impacted by the tornadoes and storms on January 21-22, 2017.
The big news was the passage of the FY 2017 Amended Budget by the House of Representatives by a vote of 173 to 1. Chairman Terry England (R-Auburn) presented the Budget in HB 43 to his colleagues which received only one question and that pertained to additional information on bonds. A few of the highlights from the Amended FY 2017 Budget:
- Within the Department of Behavioral Health and Developmental Disabilities, Adult Developmental Disabilities Services program, the House has funded an increase for 25 additional slots for the NOW and COMP waivers for the developmentally disabled to meet the requirements of the Department of Justice (DOJ) Settlement in the amount of $6,054,113 (the same amount as the Governor proposed). Also, within the Adult Mental Health Services program, the House agreed to the Governor's proposal of $6.1 million to increase funds for mental health consumers in community settings to comply with the DOJ Settlement.
- Within the Department of Community Health, Departmental Administration and Program Support program, the House added two transfers of funds of $1.1 million (from the Aged Blind and Disabled program) and $150,000 (from the Low-Income Medicaid program). The $1.1 million is to initiate contract services with an external firm for mandatory nursing home audits; the $150,000 is to be used to evaluate cost-saving measures through accurate diagnosis of ADHD through NEBA and report back to the General Assembly on that by July 1, 2017. Also, in the Healthcare Facility Regulation program, the House transferred funds from the Aged Blind and Disabled program so as to provide for an increase in the salaries for nurse surveyors it uses in the amount of $767,927. Funds remain in the Indigent Care Trust Fund from the Tenet Settlement Agreement in the amount of $11.5 million to provide the State match for DSH payments to private deemed and non-deemed hospitals. State Health Benefit Plan changes proposed by the Governor remained in the House version of the legislation (e.g., raising the funds for the five-year benefit limit for children's hearing aids from $3,000 to $6,000, and the 2 percent average increase in employee premiums for non-Medicare Advantage plans effective January 1, 2017, etc.).
- Within the Department of Education, Agricultural Education program, the House added $200,000 to fund Camp John Hope to complete the waterline infrastructure project. In the Quality Basic Education Program, the House increased the midterm adjustment due to newer numbers in the amount of $91.8 million (from $85.4 million); it lowered slightly the State Commission Charter School supplement by about $30,000 – so it still is projected to increase by more than $9.1 million; increased the midterm adjustment for charter system grants to $9.9 million (from the Governor's proposal of $9.4 million); reduced the midterm adjustment for Special Needs Scholarship from $6.5 million as proposed by Governor Deal so that this program is now cut $1.9 million; and it zeroed out the funds for training and experience for Sumter County and Hillside Conant School which were proposed to have a combined addition of $581,722 (Chairman England assured House members that this funding need was addressed elsewhere in the Budget).
- Within the Department of Human Services' Out-of-Home Care program, the House added $974,712 for DFCS foster parent per diem rates which were increased by 57 percent effective April 1, 2017 (this increase was originally proposed to begin, as per the Governor's budget, in the FY 2018 Budget) and the House also added $746,243 to provide a $1 per day increase for relative foster care providers effective April 1, 2017 (last year, legislation was passed to help kinship caregivers and these funds follow that).
Happy Birthday!! Birthdays of House colleagues were announced, including Speaker Pro Tem Jan Jones (R-Milton) on Saturday January 28 and Rep. Darlene Taylor (R-Thomasville) on Sunday January 29.
Sen. Renee Unterman (R-Buford) announced that she has proposed SR 40. That initiative recognized January 26 as Health Information Technology Day at the Capitol. Senate Appropriations Committees are scheduled to meet on Monday and Tuesday of next week to consider the AFY 2017 Budget that was approved by the House today.
HB 15, by Rep. Wendell Willard (R-Sandy Springs), seeks to require civil pleadings be electronically filed in superior and state courts in O.C.G.A. § 15-6-11 and O.C.G.A. § 15-7-5 on and after January 1, 2018. It would permit by a court rule or standing order that any superior court may provide for the filing of pleadings in criminal cases and other documents related thereto and for the acceptance of payments and remittances by electronic means. It further allows in the filing of civil filings for a court to have an electronic filing service provider which may charge reasonable fees (transaction fees are capped at $8 per transaction and a convenience fee for credit card and bank drafting services are not to exceed 3.5 percent plus $.30 per transaction).
HB 147, by Rep. Pam Dickerson (D-Conyers), proposes an amendment to current law regarding income tax credit for film, video, or digital production in Georgia so that any production company that hires a veteran (requires active duty for at least two years in the armed forces of the United States or any State's National Guard and who received an honorable discharge) who is a Georgia resident shall be entitled to additional credit in the amount of five (5) percent of the salary of each veteran employed during the State-certified production.
HB 148, BY Rep. Mike Glanton (D-Jonesboro), proposes to amend the "Quality Basic Education Act" to enact the "Educating Children of Military Families Act" by adding a new Code Section at O.C.G.A. § 20-2-324.3. It would authorize the Department of Education to establish a unique identifier for each student whose parent or guardian is an active duty military service member in the armed forces of the United States and whose parent is a member of a reserve component of the armed forces of the United States or the National Guard. Such unique identifier will be in a manner that will allow for disaggregation of data for each category.
HB 149, by Rep. Alan Powell (R-Hartwell), seeks to provide for comprehensive regulation of trauma scene cleanup services and regulated waste transport in O.C.G.A. § 35-11-1 et seq. and O.C.G.A. § 12-8-109. These entities would be required to be Georgia Bureau of Investigation-licensed entities. It further states that no county or municipal governments shall be authorized to require licenses or permits for trauma scene waste management practitioners or regulated waste transporters in this State. A license would be required from the GBI and renewed annually; trauma scene waste management practitioners and regulated waste transporters will pay initial licensing fees of $200 to the GBI and for each subsequent year an annual license renewal fee of $200. These entities would be required to undergo a criminal background check and each employee would be required to submit to a fingerprint-based criminal background check. Surety bonds, in the amount of $100,000 per entity, are also required as well as proof of liability insurance of $1 million for each occurrence.
HB 151, by Rep. Keisha Waites (D-Atlanta), proposes to prohibit the use of restraints on pregnant inmates in O.C.G.A. § 42-1-11.3 when that inmate is experiencing labor or during delivery unless that there is a reasonable basis to believe that use of such restraints is necessary to prevent the inmate from injuring herself or others.
HB 152, by Rep. Micah Gravley (R-Douglasville), seeks to address Georgia's workers' compensation laws relating to compensation for occupational disease in O.C.G.A. § 34-9-280 (this follows the pursuit of similar legislation in 2016). It proposes to include certain ordinary diseases of life attributable to the performance of the usual work of an employee within the meaning of occupational disease so that firefighters (as defined in O.C.G.A. § 25-4-2), who are diagnosed with the disease of cancer (otherwise an ordinary disease of life), is shown by a preponderance of the competent and credible evidence, including medical evidence, to have been attributable to the firefighter's performance of his or her duties as a firefighter.
HB 153, by Rep. Terry Rogers (R-Clarkesville), seeks to attach the Council on American Indian Concerns to the Department of Natural Resources for administrative purposes in O.C.G.A. § 44-12-280.
HB 154, by Rep. Sharon Cooper (R-Marietta), authorizes licensed dental hygienists to perform certain functions under general supervision of dentists in certain settings in O.C.G.A. § 43-11-74. It defines the terms "direct supervision" and "general supervision" (which means a licensed dentist has authorized the delegable duties of a licensed dental hygienist but does not require that a licensed dentist be present when such duties are performed). It adds in subsection (e) that: "The requirement of direct supervision shall not apply to the performance of dental hygiene duties at approved dental facilities of the Department of Public Health, county boards of health, or the Department of Corrections or the performance of dental hygiene duties by personnel of the Department of Public Health or county boards of health at approved offsite locations." It also amends the use of the term, "dental screening" so that it now would mean: a visual assessment of the oral cavity without the use of X-rays, laboratory tests, or diagnostic models to determine if it appears that a more thorough clinical examination and diagnosis should be conducted by a licensed dentist." It expands where the requirement of direct supervision shall not apply to the performance of licensed dental hygienists providing dental screenings in settings which are volunteer community health settings, senior centers and family violence shelters as defined at O.C.G.A. § 19-13-20. It also outlines in (g) of this Code Section a licensed dental hygienist's functions, under general supervision, which may be conducted in a private dental office setting. In subsection (h), it outlines what functions may be performed in school settings; and at (i), it outlines those functions permitted in hospitals, nursing homes, long-term care settings, rural health clinics, health facilities operated by federal, state, county or local governments, hospices, family violence shelters, and free health clinics. It requires in (k) that licensed dental hygienists performing under general supervision have at least two years of experience in the practice of dental hygiene and be compliant with continuing education requirements and cardiopulmonary resuscitation certification requirements and be licensed and in good standing. They are to also maintain professional liability insurance according to board rules and regulations. A licensed dentist may authorize up to four licensed dental hygienists to provide dental hygiene services under general supervision at any one time. Dentists are also to practice within 50 miles of the location where the dental hygienist is providing services under general supervision. It does require that the Department of Community Health collect data on utilization rates for dental services provided to recipients of Medicaid and make the data available to the General Assembly.
HB 155, by Rep. Amy Carter (R-Valdosta), seeks to create an income tax credit for expenditures by a production company related to certain State-certified musical or theatrical productions or recorded musical performances (live performance of a concert, musical tour, dance, opera, live variety entertainment, or a series of any such performances occurring over the course of a 12-month period or longer that originate, are developed, and have their initial public performance in the State or their United States debut is in Georgia) in O.C.G.A. § 48-7-40.32. It permits a production company that invests in a State-certified production to be allowed an income tax credit against tax imposed if that production company's qualified production expenditures equal or exceed the spending threshold (for musical or theatrical performance $300,000 or recorded musical performance $70,000) per taxable year. The credit is equal to 20 percent of the production company's qualified production expenditure and the entity is allowed an additional tax credit of five (5) percent of such qualified production expenditures if the State-certified production includes a qualified Georgia promotion. The legislation outlines the granting of the credit and the conditions and limitations which must be met.
HB 156, by Rep. Matt Gurtler (R-Tiger), seeks to enact the "Georgia Constitutional Carry Act of 2017." It revises several gun carry provisions in current law and among those include:
- O.C.G.A. 12-3-10(o)(2) would be deleted, making it be lawful for an individual to use or possess a handgun in a park, historic site or recreational area and it would also make it permissible for an individual to use a long gun or weapon if the person is a lawful weapons carrier.
- It adds a definition for "lawful weapons carrier" in O.C.G.A. § 16-11-125.1.
- It strips out the provisions in O.C.G.A. § 16-11-126 regarding the exceptions for homes, motor vehicles, private property and other locations and conditions for the carrying of handguns, long guns, or other weapons.
- It would permit in O.C.G.A. §16-11-127 a person who is a lawful weapons carrier to carry weapons not specifically stated or prohibited in subsections (b) and (e) of this Code Section.
- It proposes changes to current law regarding the carrying of weapons within school safety zones – and addresses violations by lawful weapons carriers (rather than license holders) and permits a lawful weapons carrier the ability to have a weapon when he or she picks up a student within a school safety zone, at a school function, or on a bus or other transportation furnished by a school if the weapon is legally kept within a vehicle
HB 157, by Rep. Trey Kelley (R-Cedartown), seeks to address requirements for advertising or publicizing of medical specialty certification in O.C.G.A. § 43-34-22.1, adding the certifying board or organization is a member board of the Bureau of Osteopathic Specialists. It further adds other requirements to be met (such as satisfactory completion of a training program with training, documentation and clinical requirements similar in scope and complexity to programs approved by the Accreditation Council for Graduate Medical Education or Bureau of Osteopathic Specialists of the American Osteopathic Association in the specialty or subspecialty field of medicine in which the physician seeks certification).
HB 158, by Rep. Ron Stephens (R-Savannah), is to be known as the Destination Resort Act" or the "Resort Act" to legalize gambling. It addresses the creation, membership, appointment and duties of a five-member Georgia Gaming Commission in Chapter 39 of Title 50. It would require this Commission to set up a Destination Resort Trust Fund to deposit all excise taxes, fees and other revenue received by the Commission and which would be used to fund the operations of the Commission and to fund investigations, regulation of limited gaming, and enforcement of this new Chapter. It grants this Commission the ability to award two destination resort licenses pursuant to O.C.G.A. § 50-39-14 in O.C.G.A. § 50-39-8(c). There are requirements for these 'resorts' to be licensed and how they are awarded in O.C.G.A. § 50-39-14 – for instance one license shall be for an entity to operate in a county with a population in excess of 900,000 according to the most recent United States census and that applicant is required to demonstrate at least $2 billion investment into this destination resort and have a minimum of 1,000 guest rooms and the other license for operation is to be in an area of at least 250,000 population and not more than 900,000 population and that applicant is to have at least a $450 million investment. Applicants are required too to demonstrate a plan for the destination resort to have over 60 percent of revenue derived from non-gaming sources. There is a permission for "limited gaming" to be permitted by a destination resort licensee – under certain conditions – as enumerated in O.C.G.A. § 50-39-20. Limited gaming facilities, though, may operate 24 hours per day of every year. In O.C.G.A. § 50-39-27, it requires that this Commission file quarterly reports with the Governor, Lt. Governor, and Speaker of the House of Representatives outlining the prior fiscal quarter information. If this legislation is passed, it will become effective on January 1, 2019 provided that the citizens approve gambling in a constitutional amendment in the November 2018 general election.
HB 159, by Rep. Bert Reeves (R-Marietta), authored this proposal addressing adoption laws in Chapter 8 of Title 19. His legislation in part addresses provisions allowing for a nonresident to allow an adoption of his or her child and addresses adoptions of foreign-born children. Additionally, the legislation changes the age for individuals to access the Adoption Reunion Registry. Some of the other amendments include:
- New definitions for terms in O.C.G.A. § 19-8-1 including "Alaskan native," "biological parent," "guardian," "Native American heritage," and "out-of-state licensed agency."
- It addresses, in O.C.G.A. § 19-8-2(b) the process for a child who has been placed for adoption with an individual who is a resident of another state in compliance with Chapter 4 of Title 39, relating to the Interstate Compact on the Placement of Children.
- It lowers the age that an individual must be to adopt a child – current law is 25 and this proposal lowers the age to 21 years of age in O.C.G.A. § 19-8-3(a)(1). It further amends the 10-year age difference exception, so that it will not apply when the petitioner is a stepparent or relative and the petition is filed pursuant to O.C.G.A. § 19-8-6 or O.C.G.A. § 19-8-7.
- It changes O.C.G.A. § 19-8-4 and when a child may be adopted through the department, any child-placing agency, or any out-of-state licensed agency under certain conditions so that each living parent and guardian must voluntarily surrender rights or had rights terminated by a court.
- There are also changes in O.C.G.A. § 19-8-24 concerning any sort of inducements or payments paid to pregnant mothers for expenses.
- There are language changes offered for O.C.G.A. § 19-8-26, relating to surrender of rights and final release for adoption and the notice required to parents/guardians; pre-birth surrender of rights; etc.
HB 161, by Rep. Betty Price (R-Roswell) would amend O.C.G.A. § 16-13-32 to provide that it shall be unlawful for a person employed by or an agent of a harm reduction organization to sell, lend, rent, lease, give, exchange, or distribute hypodermic needles designed for human use. It would define a 'harm reduction organization' as an organization which provides services such as syringe exchanges, counseling, homeless services, advocacy, drug treatment, and screening to at-risk individuals to slow the spread of HIV and other infectious diseases.
HB 162, by Rep. Betty Price (R-Roswell) would amend O.C.G.A. § 48-7-164 to provide that, if a debtor is entitled to a refund of at least $25, Administrative Office of the Courts may transfer such amount to the court to which such debt is owed, excluding the administrative collection assistance fee. It would further amend O.C.G.A. § 48-7-165.1 to provide that a superior court judge shall render a final written determination to the court to which the debt is owed.
HB 163, by Rep. Betty Price (R-Roswell), seeks to limit the use of wireless telecommunications devices while operating a motor vehicle when the driver of that vehicle is 18 years of age (O.C.G.A. § 40-6-241.2) or when the driver is operating a school bus (O.C.G.A. § 40-6-165(e)).
HB 165, by Rep. Betty Price (R-Roswell) would amend Title 43 by adding a new code section at 43-34-46 to provide that a 'maintenance of certification' shall not be required as a condition for licensure to practice medicine or as a prerequisite for hospital or staff privileges, employment in state medical facilities, reimbursement from third parties, or malpractice insurance coverage.
HB 166, by Rep, Betty Price (R-Roswell) would amend O.C.G.A. § 15-12-1.1 by adding a new subsection to provide for an exemption from jury duty for 'any person who is the operator of a licensed family child care learning home who executes an affidavit stating their position and who requests to be excused from jury duty. 'Family child care learning home' shall have the same meaning as provided in O.C.G.A. § 20-1A-2.
HR 123, by Rep. Karen Bennett (D-Stone Mountain), recognizes February 7, 2017 as Physical Therapy Day at the Capitol.
HR 126, by Rep. Sharon Cooper (R-Marietta), commends Georgians who have Type I Diabetes and whose families continually educate and advocate for their needs. It further recognizes March 16, 2017 as Type I Diabetes Day at the State Capitol.
HR 132, by Rep. Calvin Smyre (D-Columbus), recognizes February 1, 2017 as Columbus Day at the State Capitol.
HR 133, by Rep. Butch Parrish (R-Swainsboro), recognizes and honors physicians who have completed the scholarship program through the Georgia Board for Physician Workforce.
HR 135, by Rep. Dexter Sharper (D-Valdosta), commends emergency medical services professionals of Georgia and recognizes February 6, 2017 as Emergency Medical Services Day at the State's Capitol.
SB 77, by Sen. Vincent Fort (D-Atlanta), seeks to raise the age of mandatory school attendance in O.C.G.A. § 20-2-690.1 so as to require such for children between their sixth and seventeenth birthdays. Current law is at sixteenth birthday. If passed, it would become effective on July 1, 2017, and apply to the beginning of the school year 2017-2018.
SB 79, by Sen. Brandon Beach (R-Alpharetta), is the Senate version of the "Destination Resort Act" or "Resort Act" (see above the bill by Rep. Ron Stephens). This legislation provides for gambling in Title 50 and establishes the Georgia Gaming Commission.
SB 81, by Sen. Renee Unterman (R-Buford), seeks to create the "Jeffrey Dallas Gay, Jr. Act." In part it addresses the proposed permission of the State's health officer to issue a standing order permitting certain persons and entities to obtain opioid antagonists. This is codification of the Governor's order allowing the use of Naloxone as over-the-counter medication and permitted to be sold without prescription.
SB 82, by Sen. Lester Jackson (D-Savannah), seeks to amend Georgia's laws on the HOPE Scholarship and grants in O.C.G.A. § 20-3-519, where it defines a "HOPE need recipient" as a student who: A) Has met eligibility requirements to receive the HOPE scholarship or grant; B) Is not a Zell Miller Scholarship Scholar; and C) Has been claimed as a dependent on a parent's income tax returns for a period of 24 months prior to the first day of classes and where the combined annual gross income of the student's parents is less than $75,000. The definition of "HOPE need recipient" would also cover students who are solely responsible for their own care and have an annual gross income of less than $75,000 for a 24 month period. In addition, O.C.G.A. § 20-3-519.5 establishes requirements for a HOPE need recipient award for HOPE scholarship and O.C.G.A. § 20-3-519.11 establishes the eligibility requirements for a HOPE need recipient to obtain a HOPE grant.
SB 83, by Sen. Lester Jackson (D-Savannah), also addresses mandatory attendance in a public school, private school, or home school program in O.C.G.A. § 20-2-690.1 so that such will be required for children between the ages of six and 17 ½ years of age. It also addresses adult literacy and seeks to address eligibility requirements for such adult literacy programs, requiring that the individual be at least 17 ½ years of age rather than 16 years of age. Those changes are proposed for O.C.G.A. § 20-4-15(d) and O.C.G.A. § 20-4-18.
SB 86, by Sen. Jesse Stone (R-Waynesboro), addresses Georgia's laws on foreclosure in O.C.G.A. § 44-14-161 to provide that the requirement of confirmation of a foreclosure or levy sale shall not be waiveable by a grantor, mortgagor, borrower, co-borrower, obligor, co-obligor, guarantor, judgment debtor, or co-debtor prior to such sale.
SB 87, by Sen. Jesse Stone (R-Waynesboro), addresses exemptions for purposes of bankruptcy and intestate insolvent estates to provide for the discharge of judgments against exempt property in bankruptcy in O.C.G.A. § 44-13-100 (this is at any time after a debtor has been discharged from his or her debts pursuant to an act of Congress relating to bankruptcy). It further sets up the process for such discharge to occur on a motion made to the court.
SR 95, by Sen. Ellis Black (R-Valdosta), proposes an amendment to the State's Constitution to provide for the distribution of the net proceeds of a sales and use tax for educational purposes between a county school system and one or more independent school systems located in such county at Article VIII, Section VI, Paragraph IV, subparagraph (g).
House Judiciary Civil Committee – Fleming Subcommittee
The Fleming Subcommittee, chaired by Rep. Barry Fleming (R-Harlem), heard presentations on two bills today:
- HB 82, authored by Rep. Sheri Gilligan (R-Cumming), seeks to extend Georgia's identity theft statute by requiring data collectors and information brokers to notify individuals when personal information is disclosed to unauthorized persons even if such disclosure is inadvertent or accidental. The law currently requires notification for data disclosures caused by security breach, but this bill was prompted by an inadvertent data release in Forsyth County to resolve confusion about whether the county was required to notify individuals that their personal information was released. This bill would clarify that such a release would prompt notification by governmental entities that are data collectors, but it could also apply to private entities that are information brokers. The Subcommittee TABLED consideration of the bill pending clarification of the bill's language.
- HB 88, authored by Rep. Barry Fleming (R-Harlem), seeks to amend the statute setting forth qualifications for Georgia's Superior Court judges so that judges must be members of and in good standing with the Georgia Bar and would be disqualified by disbarment. The Subcommittee voted to recommend the bill DO PASS by subcommittee substitute and be sent to the full Judiciary Committee.
House Judiciary Civil Committee – Kelley Subcommittee
The Kelley Subcommittee, chaired by Rep. Trey Kelley (R-Cedartown), heard presentation on HB 1, authored by Rep. Jason Spencer (R-Woodbine), also known as the "Georgia Space Flight Act." The bill is an amendment to Title 51 of the Georgia Code to add liability limitation for space flight entities from space flight participants. This legislation was proposed during the last session, passing the House but failing to emerge from the Senate. The bill is strongly opposed by residents of Cumberland Island and Little Cumberland Island who, if a proposed coastal spaceport is ultimately authorized, will be forced to evacuate for any launch. The Subcommittee voted to recommend the bill DO PASS and be sent to the full Judiciary Committee.
House Education Committee
The House Education Committee held a brief organizational meeting today. Chairman Brooks Coleman (R-Duluth) and the other members of the Committee went around the room to introduce themselves. A few new members have been added to the Committee since last session, including Rep. Doreen Carter (D-Lithonia), Rep. Dewayne Hill (R-Ringold), Rep. Scott Hilton (R-Peachtree Corners), Rep. Dominic LaRiccia (R-Douglas), Rep. Brenda Lopez (D-Norcross), and Rep. Miriam Paris (D-Macon).
Rep. David Casas (R-Lilburn), who is the Vice Chairman of the Committee, announced subcommittee assignments. The Administration and Planning Subcommittee will be chaired by Rep. Wes Cantrell (R-Woodstock) and vice chaired by Rep. Dave Belton (R-Buckhead). The Innovation and Workforce Development Subcommittee will be chaired by Rep. Sam Teasley (R-Marietta) and vice chaired by Rep. Beth Beskin (R-Atlanta). The Early Learning and K-12 Subcommittee will be chaired by Rep. Joyce Chandler (R-Grayson) and vice chaired by Rep. Valencia Stovall (D-Forest Park).
Senate Health and Human Services Committee
This afternoon, Sen. Renee Unterman (R-Buford) and her Committee undertook a closer look at Alzheimer's Disease and the State's resources to help Georgians who are diagnosed with such disease.
Emory's Allan Levey, MD, PhD, who chairs the Department of Neurology and is the Director of the Emory Alzheimer's Disease Research Center, presented on the "epidemic" of Alzheimer's Disease. He explained that one individual every three seconds is diagnosed with dementia issues – it is an epidemic around the globe. It is projected to cost $2 trillion by the year 2030. One in nine individuals age 65 and older have Alzheimer's disease while one in three age 85 and older have the disease. Georgia has about 130,000 individuals with the disease and that number will grow to 190,000 by 2025. It is the most expensive disease in America with costs of $236 billion - more than the costs of cancer and heart disease. 70 percent of the costs are borne by Medicare and Medicaid ($160 million). Medicaid costs for individuals who died with dementia averaged more than $35,000 (versus $4,000 for a patient without dementia). 75 percent to 84 percent of dementia costs are from nursing home care and other informal or formal home care. In 2016, Georgia's Medicaid program expended almost $1 billion on Alzheimer's patients. However, Alzheimer's disease is an under diagnosed disease as two-thirds of those who meet diagnostic criteria are never receiving such a diagnosis. Only 45 percent of folks with Alzheimer's disease (or their caregivers) were ever told the diagnosis by their physician. Part of this issue relates to primary care according to Dr. Levey. There are barriers to diagnosis of this disease – such as risk of misdiagnosis; lack of knowledge of local dementia support services; disclosure could cause psychological distress; etc. However, early diagnosis will save money and reduce institutionalization. If Georgia would implement a program for early diagnosis and treatment, it could save $1.3-$1.55 billion. Georgia is the home turf to one of the 11 National Institutes of Health-recognized Alzheimer's Disease Research Centers in the nation. Georgia Alzheimer's Association is one of the largest such entities in the country, serving all 159 counties and 128,000 individuals through programs, services and online resources. Dr. Levey proposed to "fill the gap" (training, diagnosis, treatment, support services, access to clinical trials, family readiness) using a three-pronged approach (training of primary care physicians in the use of CMS's Annual Wellness Visit with a memory screen; creation of Memory Diagnostic Clinics (linked and trained by National Institutes of Health); and trained dementia care specialists to provide detailed information on and referrals to social services organizations for support services, etc.). It was interesting that Dr. Levey indicated that only 21 percent of the eligible individuals in 2015 received their annual wellness visit. If these dementia diagnostic clinics were established, the National Institutes of Health would create diagnostic and treatment protocols for memory, depression, falls and other contributing factors; provide initial and ongoing training to the clinic physicians; provide 24/7 consults to clinics; feed data into the Georgia Alzheimer's Registry; provide access to the latest clinical trials and research innovation; and collect data from clinics for the State to make future policy. He further suggested a "hub and spoke model" for such research and disease center and creating a pilot project.
Senate Finance Committee – Public Finance and Policy Subcommittee
Sen. Michael Williams (R-Cumming) chaired this Subcommittee of the Senate Finance Committee today and his Subcommittee undertook a review of SB 14 by Sen. Dean Burke (R-Bainbridge). SB 14 seeks to amend the law passed in 2016 creating tax credits for contributions to rural hospitals. SB 14 was presented by a Substitute to the Subcommittee as it will add contributions of an individual who is a member of a limited liability company, a shareholder of a Subchapter S corporation or a partner in a partnership – permitting a tax credit of 70 percent of the actual amount expended or $10,000, whichever is greater per tax year. This credit will only be allowed for the portion of the income on which such tax was actually paid by that member of such limited liability company, Subchapter S or partnership. According to Sen. Burke, only $900,000 contributions are on the Department of Revenue's records thus far (as of January 25, 2017). There was some discussion about possibly amending the 70 percent limitation on the expenditure; Sen. Burke noted for this Subcommittee that the legislation's original author, Rep. Geoff Duncan (R-Cumming), would bring forward a proposal to move that to 90 percent this Session. This Subcommittee provided a do pass recommendation on LC 34 5040S to SB 14. The legislation moves to the full Senate Finance Committee for consideration.
Our 2017 Georgia Capitol team consists of Stan Jones, Helen Sloat, Chuck Clay, George Ray, 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.