Thanks to Supplemental Rules Calendars in both chambers today, the House and Senate took up a number of weighty issues on their respective floors. In the Senate, legislators considered their version of HB 31, the State’s FY 2020 spending plan. Later, Senators considered an amended version of HB 186 that includes Certificate of Need reform measures. Not to be outdone, the House also took up major legislation, including SB 106, Governor Kemp’s “Patients First Act” and two major education initiatives relating to dyslexia and sudden cardiac arrest prevention (SB 48 and SB 60). More on these bills and other actions from the State Capitol in today’s #GoldDomeReport.

In this Report:

• Senate Passes Certificate of Need Reform, FY 2020 Budget Proposal
• House Approves “Patients First Act” and Dyslexia Pilot, Sudden Cardiac Arrest Prevention Bills
• Floor Notes
• Rules Calendars for Legislative Day 37

Senate Passes Certificate of Need Reform, FY 2020 Budget Proposal

HB 186, authored by Rep. Ron Stephens (R-Savannah), arrived today on the Senate Floor as a Substitute that includes Certificate of Need (“CON”) reform measures. The bill was carried by Sen. Chuck Hufstetler (R-Rome), who noted the Substitute reflects “a compromise between Cancer Treatment Centers of America and the Georgia Hospital Association.” The new language added to Rep. Stephens’ original bill, which addressed the state’s hospital authorities law, makes these revisions:

• Continuing to require hospitals which are wishing to get new or expanded services in the areas of psychiatric, cardiology and multi-specialty ambulatory surgery centers to go through the CON process;
• Raising capital and equipment expenditure thresholds (moving those to $10 million and $3 million respectively);
• Addressing Cancer Treatment Centers of America’s specialty cancer hospital designation and their current bed caps and allowing this facility to convert to an acute care hospital;
• Including transparency provisions for nonprofit hospitals so that they will be required to post their Form 990s;
• Requiring the Department of Community Health to standardize methodology for indigent and charity care;
• Adding language to create the Office of Health Strategy and Coordination (this was language from 2018 which was passed and later vetoed by the Governor); and
• Addressing appeals and objections to CON applications, limiting such to a 35-mile radius for facilities with the same service or if in a batching cycle with overlapping service areas.

The bill does not permit freestanding emergency departments or for Legacy Sports to be granted an exemption from the CON process as had been promoted by some of the advocates. The bill cleared the Senate by a vote of 51-4 in a new Rules Committee Substitute (which made clarifying edits to the exemption for imaging equipment and allows the Governor more leeway in his appointment to lead the new Health Strategy and Coordination Office). Those voting no on this new CON bill were Sens. Beach, Harrell, Sims, and Williams. The legislation now moves back to the House to determine whether it will agree with the compromise proposal.

The Senate also voted out its Substitute on HB 31, the FY 2020 Budget. Chairman of the Senate Appropriations Committee Sen. Jack Hill (R-Reidsville) presented the legislation to the Senate. Chairman Hill noted in part  that the budget is based on a growth rate of 2.3 percent which will be a $27.6 billion budget for FY 2020. He stated that it includes $1.9 billion in motor fuel taxes and fees and $1.24 billion in lottery proceeds. The vast majority of the budget is agreed upon with the House and includes a number of statewide changes (teacher pay raises which would begin on September 1, 2019; employee merit based pay raises; State Health Benefit Plan changes; and Teacher Retirement System funding by employer). Minority Leader Steve Henson noted his thanks to fellow lawmakers as he felt the Minority Party was heard in the process. He also stated he was excited to see the teacher pay raises included at the $3,000.00 rate but had some concerns that State employees, who are long overdue for raises, will not all be receiving such.  He asked that the Senate look more at those individuals so as to keep them competitive with others in the marketplace. The Senate approved the initiative unanimously with a vote of 55-0

House Approves “Patients First Act” and Dyslexia Pilot, Sudden Cardiac Arrest Prevention Bills

The House took up three bills of particular interest to the health and education communities today:

• SB 48, authored by Sen. P.K. Martin IV (R-Lawrenceville), amends Title 20 to require that all students in kindergarten be screened for dyslexia and provide a framework to identify and address dyslexia in students between kindergarten and grade three, subject to appropriations. The bill also requires development of a handbook by the Department of Education and collaboration in creating professional development opportunities for teachers to help them identify and intervene. The bill includes a two-year pilot program to demonstrate and evaluate the effectiveness of early reading assistance programs for students with risk factors for dyslexia, which is also dependent on appropriation. The latest Substitute to the bill extends the pilot to three years and delay requirements in the bill by three years. The House approved the bill by a 161-2 vote, and it returns to the Senate for reconciliation.
• SB 60, authored by Sen. P.K. Martin IV (R-Lawrenceville), is intended to help educate coaches and teachers about the threat of sudden cardiac arrest. The bill requires schools to post information on the warning signs of sudden cardiac arrest, hold an informational meeting for parents, and obtain informed consent before participation in sports. The bill also creates a protocol for responding to students who faint or pass out while participating in sports, and it requires medical clearance before a student who passes out or faints returns to participation. The House approved the bill by a 163-0 vote, and it returns to the Senate for reconciliation.
• SB 106, authored by Sen. Blake Tillery (R-Vidalia), is Governor Deal’s “Patients First Act.” The bill amends Title 33 to allow the Governor to apply to the federal government for a Section 1332 waiver from the Patient Protection and Affordable Care Act. It would also amend Title 45 to allow the Department of Community Health to apply for a Section 1115 Medicaid waiver that “may include an increase in the income threshold up to a maximum of 100 percent of the federal poverty level.” State law expressly prohibits the State from seeking the waivers without statutory authority from the General Assembly, and the “Patients First Act” would grant broad authority to the Governor and DCH to craft the waiver applications. The House approved the bill by a 104-67 vote, and it proceeds to the Governor’s desk.

Floor Notes

The House voted on the following other legislation of interest today:

• HR 52,  authored by Rep. John Corbett (R-Lake Park), encourages all schools, local educational agencies, and the state educational agency to recognize that dyslexia has a profound educational impact that must be addressed. The same resolution, which simply encourages action, was adopted last year. The resolution was adopted by a 155-0 vote.
• SB 66, authored by Sen. Steve Gooch (R-Dahlonega), is the "Streamlining Wireless Facilities and Antennas Act". The bill amends Title 36 to streamline the deployment of wireless broadband in the public rights of way. The House approved the bill by a 159-3 vote, and it proceeds to the Governor’s desk.
• SB 110, authored by Sen. Jesse Stone (R-Waynesboro), amends Title 15 to establish the Statewide Business Court pursuant to the Constitution. The House approved the bill by a 155-10 vote, and it returns to the Senate for reconciliation.
• SB 184, authored by Sen. Greg Kirk (R-Americus), allows participants in the SHBP to use Federally Qualified Health Centers and provides that the FQHCs will be reimbursed at Medicare rates. The House approved the bill by a 169-1 vote, and it proceeds to the Governor’s desk.
• SB 225, authored by Sen. Larry Walker, III (R-Perry), seeks to make necessary changes in Georgia law so as to permit the state to enact the federal law, “Family First Prevention Services Act.”  The initiative makes several revisions in Chapter 11 of Title 15, including adding a number of new definitions into the Georgia Code (e.g. what is a “qualified residential treatment program”).  It also makes changes relating to the Indian Child Welfare Act so as to keep Georgia in compliance with that Act and makes revisions to DFCS’ notification and records keeping processes for youth who leave the care of DFCS or age out of the foster care system. The House approved the bill by a 158-1 vote, and it returns to the Senate for reconciliation.

The Senate voted on the following other legislation of interest today:

• HB 63, authored by Rep. Sharon Cooper (R-Marietta), establishes a step therapy program for health benefit plans in Chapter 24 of Title 33.  The legislation was carried on the Senate Floor by Sen. Kay Kirkpatrick (R-Marietta) who explained that there were exceptions put into the bill so that provider’s justification for a particular drug is justified when documented if 1) the required drug is contraindicated or will cause an adverse reaction of physical or mental harm to the patient; the required prescription drug is expected to be ineffective based on the known clinical condition of the patient and the known characteristics of the prescription drug regimen; the patient has tried the required prescription drug or another drug in the same pharmacological class or with the same mechanism of action as the required drug while on their current or immediately preceding health plan and such drug was discontinued due to lack of efficacy, diminished effect or an adverse event; or the patient is receiving a positive therapeutic outcome on a prescription drug for the medical condition under consideration if while on their current or immediately preceding health plan, the patient received coverage for the prescription drug and the practitioner documents same)..  This new program would become effective on January 1, 2020.  This bill passed 49-0.  This bill requires further action by the House so that it will need to approve changes made in the Senate.
• HB 64, authored by Rep. Brian Prince (D-Augusta), addresses Chapter 7 of Title 19.  It seeks to address instances where children of military families are subject to abuse allegations. For each child who is the subject to abuse allegations the child welfare agency is to determine whether the parent or guardian of such child is on active duty in the armed forces of the United States.  If so, the agency is to notify the applicable military installation’s family advocacy program of the allegation of child abuse that relates to the parent or guardian of that child.  This legislation passed 51-0.  The bill moves to the Governor’s desk.
• HB 130, authored by Rep. Randy Nix (R-LaGrange), authorizes the Georgia Foundation for Public Education to establish a nonprofit corporation so that it may take donations of funds.  This legislation passed by a vote of 52-0. The legislation moves to the Governor’s desk.
• HB 217, authored by Rep. Houston Gaines (R-Athens), implements a syringe services program so as to allow exchanges of dirty needles to help prevent the spread of HIV/AIDS and Hepatitis C disease. This bill passed with a vote of 45-4 and moves to the Governor’s desk.
• HB 227, authored by Rep. Spencer Frye (D-Athens), seeks to address insurance policies so that there is no discrimination against victims of family violence as well as victims of sexual assault.  This bill passed with a vote of 38-12 after several attempts were made to make amendments to the proposal by Sens. Brass, Kennedy and Cowsert.  The bill moves to the Governor’s desk.
• HB 287, authored by Rep. Matt Dubnik (R-Gainesville), which makes a change in Title 48 to an income tax deduction so as to allow it to become a tax credit for physician, physician’s assistants and APRN preceptors who are training healthcare professionals.  This legislation passed by a vote of 41-9 and now moves to the Governor’s desk.
• HB 311, authored by Rep. Andy Welch (R-McDonough), is this year’s sovereign immunity bill as it relates to actions ex contracts and state tort claims.  It passed with a vote of 49-0 by Substitute; it now requires further House action to agree to the changes made in the Senate.
• HB 483, authored by Rep. Ron Stephens (R-Savannah), is the annual drug update in Chapter 13 of Title 16.  This legislation passed with a vote of 48-1.This legislation moves to the Governor’s desk.

New Legislation

The following legislation of interest was introduced in the House and Senate today. Because these items have been introduced after Crossover Day, they are not eligible for consideration by the both chambers before 2020 (with exception of House and Senate study committees).

• HB 662, authored by Rep. Tommy Benton (R-Jefferson), amends Title 47 to require that actuarial investigations in the Teachers Retirement System occur at least once in a three year period. The bill also requires that the maximum annual assumed rate of return shall not exceed 6%. This bill was referred to the House Retirement Committee.
• HB 667, authored by Rep. Chuck Martin (R-Alpharetta), amends Title 47 to require that actuarial investigations in the Teachers Retirement System occur at least once in a three year period. The bill also requires that the maximum annual assumed rate of return shall not exceed 6% and that on or after July 1, 2020 the retirement system shall employ a three-year direct interest rate smoothing for actuarial determined employer contributions. This bill was referred to the House Retirement Committee.

Rules Calendars for Legislative Day 37

The House will take up the following propositions on Tuesday for Legislative Day 37:

• SB 9 -- Invasion of Privacy; sexual extortion; prohibit; definitions; elements of the crime; provide
• SB 29 -- Waiver of Immunity for Motor Vehicle Claims; definition to clarify sheriff, deputy sheriff, other agent, servant, or employee of sheriff's office; include
• SB 65 -- Alternative Ad Valorem Tax on Motor Vehicles; transfer of a title between legal entities owned by the same person; not constitute a taxable event; provide
• SB 75 -- State Board of Veterinary Medicine; professional health program for impaired veterinarians; provide
• SB 79 -- Outdoor Advertising; references to the term "mechanical" in relation to multiple message signs; remove
• SB 83 -- Quality Basic Education; elective courses in History and Literature of the Old and New Testament Eras; provisions; revise
• SB 118 -- Insurance; Georgia Telemedicine Act; modernize; Telemedicine Act the Telehealth Act; rename
• SB 127 -- Motor Fuel Tax; electronic filing of certain reports; require
• SB 153 -- Trauma Scene Cleanup Services; comprehensive regulation; provide
• SB 157 -- Public Funds; when funds shall be considered to held by a depository; specify; State Depository Board certain policies and procedures related to deposit placement programs; establish
• SB 158 -- "Anti-Human Trafficking Protective Response Act"
• SB 168 -- Nurses; certain definitions; revise
• SB 207 -- Georgia Board for Physician Workforce; change name; board's membership; revise

The Senate will take up the following propositions on Tuesday for Legislative Day 37:

• HB 26 -- Psychology Interjurisdictional Compact; enter into an interstate compact
• HB 59 -- Education; military students enroll in public school based on official military orders prior to physically establishing residency; allow
• HB 83 -- Quality Basic Education Act; recess for students in kindergarten and grades one through five; provide
• HB 171 -- Motor vehicles; use of mounts on windshields for the support of wireless telecommunications devices and stand-alone electronic devices under certain circumstances; allow
• HB 213 -- Georgia Hemp Farming Act; enact
• HB 253 -- Professions and businesses; occupational therapists; update and revise various provisions
• HB 264 -- Public officials' conduct and lobbyist disclosure; persons promoting or opposing any matter regarding the EMSC Program are subject to transparency and lobbyist disclosure laws; provide
• HB 315 -- Local government; certain agreements from consultants who enter into contracts or arrangements to prepare or develop requirements for bids; provide
• HB 323 -- Insurance; administration of claims by pharmacy benefit managers; revise provisions
• HB 344 -- Ad valorem tax; real property owned by certain purely public charities if such real property is held exclusively for the purpose of building or repairing single-family homes to be financed to individuals using no-interest loans; exempt
• HB 346 -- Property; prohibit retaliation by a landlord against a tenant for taking certain actions
• HB 373 -- Labor, Department of; employment security; change certain provisions
• HB 392 -- Board of Public Safety; expense allowance and travel cost reimbursement for members in like fashion as other state boards and commissions; provide
• HB 459 -- Education; driver's license verification system for school bus drivers; provide
• HB 493 -- Private Permitting Review and Inspection Act; enact