Legislators push back on some cuts

Threat to funding of health care initiatives sparks resistance.

Legislators writing the Georgia budget said they will push back at cuts to health care funding proposed by Gov. Brian Kemp.

“It’s pretty obvious we’re not excited about these cuts,” state Rep. Butch Parrish, R-Swainsboro, told the head of one state agency testifying Tuesday before a House Appropriations subcommittee on health funding. He said the Legislature had spent years trying to understand and fight key health care problems in the state, especially in rural areas, and finally had programs hitting the ground to do that.

“It appears that the cuts are all the new programs that we have added over the last few years,”

Parrish said. “And we’re going to take a long hard look at that.”

Proposed cuts would affect

money to keep doctors from leaving rural Georgia; testing kits to stem a hepatitis C outbreak in North Georgia; and a new staff position to handle complaints about problem doctors more quickly. Reductions would also include a slice of the funding for the state’s poison control center, and part of the money that funds county health departments.

State executives who run health agencies detailed all those proposed cuts Tuesday, and there are more hearings to come.

The proposals didn’t make legislators happy.

Kemp ordered 4% budget cuts this fiscal year and 6% cuts next year for many agencies in order to deal with a slowdown in tax collections and pay for his top priorities, such as a second big teacher pay raise.

His aides have said the governor’s proposals are surgical and in each case they worked to find the least intrusive way to reduce spending in the face of less tax revenue. They emphasize the programs that the budget does fund.

That doesn’t mean all the cuts can be done without reducing services that are already on the ground.

One of the most discussed cuts is to grants awarded to county public health departments, which work to prevent epidemics, reduce health risks and perform other tasks that may vary from county to county.

Public Health Commissioner Kathleen Toomey has said there will be no reductions in services in her department, or minimal reductions. If freezing open positions doesn’t do the job, she said, to keep things stable, county departments can spend more of their own money or fundraise.

It’s not so easy, legislators said.

“In some of, especially our smaller, rural counties, they have a very difficult time raising money,” Parrish

said after the hearing. “They don’t have the base that’s there like the business or tax base to raise that.”

One of the cuts proposed for the Department of Public Health went to money the state spends on testing kits to combat hepatitis C, which has spread in North Georgia. A spokeswoman for Toomey said the department would continue to prioritize the districts with the greatest hepatitis C risk when deciding where to distribute the remaining 1,700 kits.

State Rep. Lee Hawkins, R-Gainesville, said it was “painful” to see cuts to a program that subsidizes doctors and other professionals in rural areas in order to persuade them to keep working there. Half of Georgia’s counties have no ob/gyn, and a handful have no doctor at all.

The program is already subsidizing 37 doctors, but the state funded an additional 13. Doctors applied for the slots, but the recent budget proposal would cut the program back to 37. The same with nurses and physician’s assistants, which went back from 25 slots each to 20.

“It’s sort of a yo-yo effect,” Hawkins said. “They make plans based on what we’re telling them we’re going to do. And then we say, ‘Well never mind,’ you know? ... If we can find some money to fix this, we’re going to look for it I think.”

Even in cases where spending was left untouched, legislators felt stymied in trying to make improvements.

State Rep. Pat Gardner,

D-Atlanta, said her constituents had read The Atlanta Journal -Constitution’s series on assisted living facilities and large personal care homes “and they’re asking what are we doing about it.”

Speaking to witnesses from the Department of Community Health, Gardner said: “And if you’re saying to us, ‘We feel relieved we didn’t lose any money,’ that doesn’t help us.”

The AJC’s series found gaps in the state’s oversight system that failed to protect seniors and too often left them in the dark about problems. The newspaper identified some 600 cases of neglect and 90 involving abuse, as well as 20 deaths linked to problems with care. The worst offenses often resulted in little more than a $601 fine.

The DCH division that regulates the homes, Health Facility Regulation, was spared from cuts in the governor’s proposed budget. But the newspaper’s investigation found the small platoon of DCH inspectors struggled to keep pace with the fast-growing industry and that the agency doesn’t have enough staff to carry out inspections once a year. The proposed budget leaves its staffing unchanged.

DCH Commissioner Frank Berry said the department had been working on improvements before the AJC’s series ran and “it’s a process.” He said the department was wary of making quick changes that could have unintended consequences such as closing down a needed home in a sparse area.

He noted that the department had already implemented background checks. “That was the first bite at a big apple,” he said.

Parrish, the subcommittee chairman, said changes were coming to Kemp’s budget, no matter that the governor wields the veto pen.

“It’s my understanding that he recommends and the General Assembly appropriates,” Parrish said.