Georgia legislative sessions during election years tend to be quick and fairly quiet, without a lot of “heavy-lift” proposals being passed.
The 2018 General Assembly session may follow that trend.
Still, House Speaker David Ralston (R-Blue Ridge) addressed several health care issues Thursday that may at least draw interest during the 2018 General Assembly session:
certificate of need, rural access to health care, medical marijuana, hands-free cellphone use, Medicaid “waivers.”
At a Capitol press conference on the upcoming General Assembly, Ralston indicated that health care and the recommendations of the House Rural Development Council are among his top legislative priorities for the session, which begins Jan. 8.
After the session ends early in the year, many officials will have to get back to campaigning. In November, Georgia will have its elections for the governorship, other statewide offices and every seat in the General Assembly.
Despite the expected volatile political atmosphere with elections in sight, Ralston told reporters that “there are communities [in rural Georgia] that really can’t wait much longer for jobs, for better schools and health care access.”
The Rural Development Council, a group of influential House members, recently made several recommendations for legislation to improve the economy and health care of these areas. Among the proposals was pushing for an expansion of broadband Internet through rural areas of the state, which would aid remote monitoring of patients and telemedicine.
Ralston said he prefers to incentivize private Internet carriers to develop this capability, rather than allocating state funding for this purpose.
Certificate of need
A council proposal included a fundamental reform of the state regulatory licensing program for health care facilities, known as certificate of need, or CON.
“They’ve put a lot of good thought into that,” he said.
He said he is not currently advocating CON changes.
“We’re going to have to have a discussion about CON going forward,” he said.
The Georgia Hospital Association and the Georgia Alliance of Community Hospitals have already signaled opposition to any CON revamp.
The Rural Development Council also backed facilitating the concept of a “micro hospital,” which could resemble Piedmont Healthcare’s standalone emergency room in Ellijay. Ralston said he believes that tweaking laws other than CON regulations could address the micro hospital situation.
“I think there’s a growing recognition that [small] communities … can’t support a 40-bed or 50-bed hospital,” Ralston said. “They do need health care access provided by an emergency room with a small number of beds for very short-term care.”
He said he is not opposed to adding people to the Medicaid rolls by seeking a federal “waiver,” which could allow a program tailored to fit the needs of Georgia. The waiver idea to expand coverage was another recommendation of the House Rural Development Council.
“I have generally supported the concept of Medicaid waivers,” he said.
Part of the problem with the Affordable Care Act, Ralston said, is that it has been a “one size fits all” solution.
“Different states have different needs,” he said.
The uncertainty over congressional attempts to repeal and replace the ACA, though, clouds the waiver process, Ralston said.
“I think we’re still in a period of uncertainty, with decisions going on in Washington,” he said.
“At the end of the day, we have to pay for these things,” he added. “Our sources of money are not unlimited. “
Ralston said passing legislation to modernize Georgia’s adoption laws is a priority for him. An attempt to make the process more efficient for families failed at the end of last year’s General Assembly. Passing the bill would “get kids out the foster system and into permanent, stable and loving homes quicker,” he told reporters.
Opioid crisis funding
Asked whether he supported state funding to combat the opioid epidemic, Ralston said, “We may get to that point, because it is an epidemic. I would want to know how effective it would be. “
The opioid situation is a particular problem in rural Georgia, he said. The opioid epidemic, he added, “is a huge, huge, devastating crisis.”
Georgia, like other states, has seen an increase in overdose deaths from opioids, which can include prescription drugs, heroin and other street drugs.
Rep. Allen Peake (R-Macon) is expected to push a bill to allow cultivation of medical marijuana within the state, to avoid having to import it across state lines.
“At some point, we have to confront the reality that as long as federal law is what federal law is, there’s only so far that we can go,” Ralston said.
While federal laws against marijuana remain in effect, the feds have been lenient on legalization within states, though U.S. Attorney General Jeff Sessions signaled a tougher line Thursday.
Hands-free cellphone use
Rep. John Carson (R-Marietta) did “great work” chairing a study committee on distracted driving, Ralston said. Separately, Smyrna recently became the first Georgia city to ban handheld devices while driving. Distracted driving “is a problem. Finding the balance on a solution is a challenge,” Ralston said.