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2019 Georgia General Assembly
Update: Tuesday, April 9, 2019
The General Assembly adjourned last Tuesday, April 2 at midnight ending its annual 40-day session. It was a year that did not see many major issues impacting pediatrics but did have several bills of significance. One troubling exception to that was the introduction of two anti-vaxx measures: one a bill to create a “consumer protection for vaccines body” and another to urge Congress and UGA to study “vaccine injuries.” While there bills did not even get committee hearings, it marked that first time in memory that such anti-immunization measures were even introduced in the Georgia General Assembly.
Also, because the state legislature technically works in “biennial” or 2-year sessions, and 2019 was the first year of the biennial, any bill that did not pass this year will be “alive” for consideration in 2020. However, bills that were defeated this year, will have to be re-introduced. Also, the legislature commonly forms, by Resolution, Study Committees. They often serve as a precursor to future legislature on the matter. Here’s a list of the bills we followed and their final status. We’ve provided it in 4 Sections: Passed, Failed, Did Not Pass but Alive for 2020; and Study Committees. Thank you to the Chapter Legislative Committee, chaired by Melinda Willingham, MD and all the members who attended our weekly conference calls during the session.
THE FOLLOWING BILLS RECEIVED FINAL PASSAGE
CARDIAC ARREST — SB 60 by Sen. P.K. Martin (R-Lawrenceville) would require the Georgia DOE to develop and post on its website guidelines and other materials to inform students, parents, guardians and coaches about the nature and warning signs of sudden cardiac arrest.
CERTIFICATE OF NEED (CON) / HEALTH STRATEGY & COORDINATION — HB 186 by Rep. Ron Stephens (R-Savannah) became the compromise CON bill of the 2019 session. The bill would provide for an increase in CON capital expenditure thresholds to $10 million and an increase to $3 million for equipment. It would clarify that freestanding emergency departments would be required to obtain a CON regardless of project expenditures. It would allow Cancer Treatment Centers of America’s hospital in Newnan to convert from a destination hospital to a general hospital but requires them to get a CON prior to converting, therefore being subject to the same CON regulations as all other hospitals. The bill does not provide for any exemptions to CON, including no exemptions for multi-specialty ASCs, Legacy Sports Institute, and cardiac procedures in ASCs. Final bill also included SB 151, the Office of Health Strategy and Coordination.
DYSLEXIA — SB48 by Sen. P.K. Martin (R-Lawrenceville) requires a pilot program for pre-kindergarten students to be screened for dyslexia & provide information, etc.
FAMILY FIRST — SB 225 by Sen. Larry Walker (R-Perry) would amend the Juvenile Court code to bring its provisions in conformity with the federal Social Security Act and the Family First Prevention Services Act.
FETAL HEARTBEAT — HB 481 by Rep. Ed Stetzer (R-Acworth) would make it illegal for a physician to perform an abortion once fetal heartbeat is detected. (Medically, this happens between 6-8 weeks.) This would conflict with Roe v. Wade so would be likely challenged on that basis if it passes the Legislature.
HEALTH STRATEGY & COORDINATION — HB 186 (formerly SB 151 by Sen. Dean Burke (R-Bainbridge), create the Office of Health Strategy and Coordination which would provide a forum to share information between state departments, coordinate the major functions of the state’s health care system, and develop innovative approaches for stabilizing costs while improving access to quality health care. Added to HB 186. This bill was vetoed by Governor Deal last year as an “unnecessary expansion of government. “
HEALTHY HOUSING — HB 346 by Rep. Sharon Cooper (R-Marietta) would prohibit retaliation against tenants who complain of unsafe and unhealthy housing conditions for Code Enforcement. This would serve to protect children with asthma who live in unhealthy homes.
KRATOM/PDPM FINES — HB 551 by Rep. Dewayne Hill (R-Ringold) would prohibit access to kratom to persons under 18 years of age and to provide for package labeling requirements for the sale of kratom. The bill was amended by the House to include language that would address the fines for physicians who were not registered for the Prescription Drug Monitoring Program (PDMP) prior to the deadline. This action has the effect of making more reasonable the penalties for not registering for the PDMP due to oversight or misunderstanding. We welcomed this action, which was brought forth by Rep. Sharon Cooper, R-Marietta.
LOW THC OIL PRODUCTION — HB 324, Rep. Gravley (R-Douglasville) would allow for the production, manufacturing, and dispensing of low THC oil.
MEDICAL LICENSURE COMPACT — SB 16 by Sen. Kay Kirkpatrick (R-Marietta) is a MAG supported bill that would allow the Georgia Composite Medical Board to administer the Interstate Medical Licensure Compact in Georgia.
MEDICAID WAIVERS — SB 106, the Patients First Act by Sen. Blake Tillery (R-Vidalia), one of the Governor’s Floor Leaders, empowers the executive branch to seek waivers from the federal government for Medicaid and the Affordable Care Act (ACA). Specifically, the bill permits the Governor to apply to the federal government for a Section 1332 waiver from the ACA and would also to allow the Department of Community Health to apply for a Section 1115 Medicaid waiver that “may include an increase in the income threshold for Medicaid eligibility to up to a maximum of 100 percent of the federal poverty level.”
MENTAL HEALTH REFORM — HB 514 by Rep. Kevin Tanner (R-Dawsonville) creates the Mental Health Reform and Innovation Commission. The legislation also establishes five subcommittee including on Child and Adolescent Mental Health.
PRECEPTOR TAX CREDIT — HB 287 by Rep. Matt Dubnik (R-Gainesville) creates the Preceptor Tax Incentive Program, a new income tax credit for taxpayers who are licensed physicians, advanced practice registered nurses, or physician assistants and who provide uncompensated preceptorship training to the same.
REQUIRE RECESS — HB 83 by Rep. Demetrius Douglas (D-Stockbridge), would require schools to provide 30 minutes of daily recess.
SHACKLING of Pregnant women inmates, prohibit — HB 345 by Rep. Sharon Cooper (R-Marietta) provides for new inmate policies for pregnant woman, including juveniles, confined to a penal institution. Specifically, the bill would prohibit the use of handcuffs, waist shackles, leg irons, or restraints of any kind on a woman who is in the second or third trimester of pregnancy, in labor, in delivery, or in the immediate postpartum period.
STEP THERAPY — HB 63 by Rep. Sharon Cooper (R-Marietta) would require health benefit plans to establish step therapy protocols.
TELEMEDICINE LICENSURE / VACCINE PROTOCOL AGREEMENT — SB 115 by Sen. Unterman (R-Buford) provides for telemedicine licenses for physicians licensed in other states to practice with Georgia. The final version of the bill also includes language from HB 214, the Vaccine Protocol Agreement legislation, but with proviso that physician must reside in Georgia.
TELEMEDICINE INSURANCE COVERAGE — SB 118 by Sen. Unterman (R-Buford) would require that all health insurance policies cover “appropriately provided telehealth services.”
THE FOLLOWING BILLS DID NOT RECEIVE FINAL PASSAGE:
DNR FOR MINORS — SB 104 by Sen. Chuck Payne (R-Dalton) proposes to revise the parental requirements for consent to an order for do not resuscitate for a minor child. UPDATE: Passed Senate. Approved by House Judiciary Committee but never made it on a House Rules Calendar.
PRESCRIPTION DRUG BENEFITS — SB 195 by Sen. Chuck Hufstetler (R-Rome) creates the Prescription Drug Benefits Freedom of Information and Consumer Protection Act that requires pharmacy benefit managers and insurers to post formulary information on their websites. It also requires the Commissioner of Insurance to adopt rules to promote consistency and clarity in the disclosure of formularies and to create a single, standard form for requesting prior authorization. It would also create an Advisory Committee on Uniform Prior Authorization and includes fines for violations of the rules/regulations for prior authorization. UPDATE: Passed Senate on March 7. Passed House on March 28 but original bill was stripped out and now the bill is about travel insurance. Bill went back to the Senate, which disagreed to the House substitute bill.
SURPRISE BILLING — HB 540 [formerly SB 56] by Sen. Chuck Hufstetler (R-Rome) has also introduced legislation to address surprise billing that is supported by MAG. SB 56 passed Senate on March 5 but stalled in the House Insurance Committee. UPDATE: Like last year, the opposing parties could not agree on a compromise and both bills died.
THE FOLLOWING BILLS FAILED TO PASS THIS SESSION BUT REMAIN ALIVE FOR THE 2020 SESSION:
- ANTI-VAXX BILL—“Consumer Protection Office”, est — HB 416 by Rep. Rick Williams (R-Milledgeville) would create a State Vaccine Consumer Protection Office, create a committee of anti-vaccine consumers, and provide information on assessment, Dx, and treatment of potential vaccine injuries. Assigned to House Health and Human Services Committee and received no consideration this session.
- VACCINATIONS: MINORS SELF-CONSENT — HB 615 by Rep. Teri Anulewicz (D-Smyrna) would allow minors who are 16 or 17 years of age to receive vaccinations without parental consent. Assigned to the Health and Human Services Committee.
- Anti-Vaxx Resolution: VACCINE INJURY — HR 648 by Rep. Ed Setzler (R-Milledgeville) introduced an urging resolution in the House recognizing “vaccine injuries, their required reporting and compensation and do hereby urge the U.S. Department of Health and Human Services and the University System of Georgia to fund additional vaccine-injury related research. The resolution was assigned to the House Health and Human Services Committee, which did not take up the measure
APRN SCOPE OF PRACTICE – ORDER IMAGING — SB 109 by Sen. Larry Walker (R-Perry) and HB 409 by Rep. Alan Powell (R-Hartwell) would allow APRNs to order radio-graphic imaging tests in non-life-threatening situation. Senate Health Committee modified the Senate bill to require that nurses must have a minimum of five years in practice to be able to order radiological tests in non-emergent situations. It was scheduled for a vote by the Senate on March 5 but the bill was tabled and not considered this session because the National APRN organization objected to the Senate amendment limited it to nurses with a five years of practice. Over in the House, the House Special Committee on Access to Quality Health Care held a hearing on HB 409 but no action was taken.
CONVERSION THERAPY — HB 580 by Rep. Matt Wilson (D-Brookhaven) would prohibit the practice of conversion therapy. Referred to the Regulated Industries Committee. (Introduced late in session.)
DEXTROMETHORPHAN — HB 112 by Rep. John LaHood (R-Valdosta) would prohibit the sale to and by minors of drug products containing dextromethorphan (a medication most often used as a cough suppressant in over-the-counter cold and cough medicines). Assigned to the Juvenile Justice Committee.
HANDHELD ELECTIONIC DEVICES — HB 113 by Rep. John Carson (R-Marietta) specifies that anyone driving with a Class C learners permit, Class C license, or Motorcycle instruction permit is prohibited from using a stand-alone electronic device or wireless telecommunications device unless it is an emergency. Passed Public Safety Committee.
SEVERAL GUN BILLS WERE INTRODUCED But None Moved
- HB 20, HB 58, HB 137, SB 150 all proposed to prohibit gun ownership by individual convicted of misdemeanors crimes of family violence. Public Safety.
- HB 55 by Rep. Roger Bruce (D-Atlanta) would prohibit using 3-D printer to produce guns. Public Safety
- HB 122 and SB 50 were introduced by Democrats in the House and Senate to repeal the Campus Carry law passed in 2017. Public Safety
- SB 224 by Sen. Tyler Harper (R-Ocilla) would eliminate the exception for allowing places of worship to determine if they want to allow the carrying of weapons or long guns by license holders on their premises. It also would limit the carry of weapons in courthouses to only include superior court proceedings. The bill would also allow persons convicted of any misdemeanor involving the use or possession of a controlled substance to apply for a weapons license. Was approved by the Senate Judiciary Committee on March 4thbut failed to make it by Crossover day .
JUVENILE SHACKLING — HB 438 by Rep. Mandi Ballinger (R-Canton) proposes to restrict shackling of children to only those cases where the child poses a real risk to the courtroom. Unless the Georgia Supreme Court adopts a court rule to address this issue, this legislation is expected to considered next session. Assigned to the Juvenile Justice Committee, which is chaired by Rep. Ballinger.
SURPRISE BILLING — HB 84 by Rep. Richard Smith (R-Columbus) and SB 56 by Sen. Chuck Hufstetler (R-Rome) both attempt to address the issue of surprise medical bills. But the two powerful sponsors of this legislation can’t agree on the solution, so a legislative remedy continues to be elusive.
SWIMMING POOLS — HB 477 by Rep. Ron Stephens (R-Savannah) would exempt pools located in condominium complexes from being required to obtain a permit for operation from the Department of Public Health. Assigned to the State Planning and Community Affairs Committee.
STUDY COMMITTEES: The following study committees were authorized to meet over the interim (between now and 12-31-19)
PANS/PANDAS — HR 590 by Rep. Karen Bennett (D-Lithonia) creates the House Study Committee to study the conditions, needs, issues and problems associated with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection (PANDAS).
INFANTS & TODDLERS — HR 421 by Rep. Katie Dempsey (R-Rome) creates the House Study Committee on Infant and Toddler Social and Emotional Health to focus on early intervention and prevention of mental health problems in children and adolescents.
MID-LEVEL PROVIDERS — HR 261 by Rep. Mark Newton (R-Augusta) creates the House Study Committee on Evaluating and Simplifying Physician Oversight of Physician Assistants and Advanced Practice Registered Nurses while SR 202 by Sen. Chuck Hufstetler (R-Rome) creates the Senate Study Committee on Evaluating and Simplifying Physician Oversight of Physician Assistants and Advanced Practice Registered Nurses. While each chamber passed the study committee specific for their body, it is expected that the two study committees will meet jointly.
HEAT-RELATED INJURIES — HR 259 by Rep. William Boddie (D-East Point) creates the House Study Committee on Heat-Related Injuries, Cardiac Injuries, and Other Sports-Related Injuries
MATERNAL MORTALITY — HR 589 by Rep. Mark Newton (R-Augusta) creates the House Study Committee on Maternal Mortality. The Study Committee is charged with studying the issues related to maternal mortality.
HEALTH CARE REIMBURSEMENT — HR 644 by Rep. Lee Hawkins (R-Gainesville) creates the House Study Committee on Health Care Reimbursement to study the current health care system and the various types of payors and identify any possible changes to such health care system to address the differentials in health care reimbursement.
NURSE STAFFING — HR 448 by Rep. Sharon Cooper (R-Marietta) creates the Joint Study Committee on the Safe Staffing of Nurses in Georgia.
RDC — HR 214 by Rep. Sam Watson (R-Moultrie) reauthorizes the House Rural Development Council for another two years.
CHARITY CARE CREDITS — HR 584 by Rep. Todd Jones (R-South Forsyth) creates the House Study Committee on Exploring a Floor and Trade Charity Care System, which will focus on a credit program for Indigent and Charity Care (ICC) provided in the state that hospitals would buy and sell according to their need to meet ICC requirements.
INNOVATION & EMERGING TECHNOLOGIES — HR 408 by Rep. Ed Setzler (R-Acworth) creates the Joint Innovation and Emerging Technologies Study Committee.
House Appropriations Committee Leadership
Terry England, Auburn
Rep. Butch Parrish, Swainsboro
Chair, Sub-committee on Community Health/Medicaid
Rep. David Ralston, Blue Ridge
Speaker of the House
Senate Appropriations Committee
Lt. Gov. Geoff Duncan, Alpharetta
Sen. Mike Dugan, Carrollton
Senate Majority Leader
Sen. Butch Miller, Gainesville
Senate President Pro Tem
For a complete text of any these bills you can visit the Georgia General Assembly website: www.legis.state.ga.us. For more information on these or other bills, contact Rick Ward, at the Chapter office, at email@example.com. Thanks to the members of the Legislative Committee for their efforts during the session and to all our members who contacted their legislators about our issues. Your support and participation in the legislative process is vitally important to our advocacy.