Comité Public and Community Health de la Cámara de Representantes, 5 de marzo de 2026

Transcripción

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1. 0:14:45

   Okay, am I ready?

2. 0:14:46

   That's something to

3. 0:14:48

   Okay, guys. All right. Uh, good afternoon, everybody. Thank you for being patient with us. We had to get a quorum. Uh, everybody is going everywhere, so I appreciate my members being here.

4. 0:15:03

   Right.

5. 0:15:03

   Um, and with that, we are gonna call this meeting of the Health and Human Services Committee to order, and I am going to take the chairman's prorogatie. Pornography? Porog- uh, la, la, la.

6. 0:15:18

   Prorogative.

7. 0:15:18

   Prorog- I can't say it. Something's wrong with my... It's probably 'cause I've been rushing and I don't have enough oxygen. I'm going to present 500 first. Uh, this is my bill. For about three years now, this bill has been presented first by Tyler Paul, and he was so busy this year, he finally told me to go put my name on it, and it's about our Temporary Assistance for Needy Families Act, and it's where some of our most needy Georgians go to ask for help.

8. 0:15:55

   And I will tell you that the money we give them, which is just bare minimum, has not been raised in 30 years. So when we got a, uh, a, a fiscal note and it came back, the cost was so great that the commissioner asked me, uh, to not call the bill then, um, because of the cost of the increase of the money it would cost.

9. 0:16:31

   But that was based on giving the beneficiaries cash. So we talked, and what we came up with, and the commissioners, you know, knows this and she was with me, that it would be okay to move forward with one other thing, which might help them a bit. The most they could have in cash reserves was, like, $2,000 under what's been going on for 30 years, and they could only have a vehicle that was worth about $2,500.

10. 0:17:06

    Anybody tried to drive a vehicle worth $2,500? Pretty hard and pretty, you know, significant. Uh, especially since many of the people that get assistance from this program are a lot of our grandparents who are taking children that would be in foster care and taking them to raise. And what little bit they're getting helps, but it's such a small amount.

11. 0:17:39

    But then they are having to get them to school and, you know, there's always some kind of an extra little something that a child needs, and they're bearing the brunt of this to a great degree. So what I have is a substitute and, you know, it's very clear. It's back on starting on line 21. It just says the resources of an applicant shall not exceed $5,000. They can have one vehicle, doesn't say how much, if it's being used for work, training, education, m- m- you know, or trying to find a job.

12. 0:18:11

    And they have another exclusion that they can have another vehicle if its value is not more than $4,650. And the commissioner thought that this would be all right for the bill to move forward with that.

13. 0:18:28

    I'll be glad to take any questions.

14. 0:18:32

    Uh, w- oh, sorry.

15. 0:18:34

    I'm sorry.

16. 0:18:34

    Uh, Representative Au.

17. 0:18:36

    Her light went up first.

18. 0:18:37

    Oh, my. Sorry.

19. 0:18:38

    So.

20. 0:18:40

    Sorry. Thank you, Madam Chair, for carrying this bill on this really important issue that I know you've been caring about and working on for a very long time. I just wanted to put one point of clarification to emphasize why this is so needed, is actually the minimum amount that, um, a family can hold in assets is, is only $1,000, not $2,000. So you can imagine-

21. 0:19:01

    Okay

22. 0:19:01

    ... that it makes it very difficult to qualify.

23. 0:19:03

    Oh, yeah. Oh, yeah.

24. 0:19:04

    Oh, yeah, but no, but you're correct that this is, is very urgently needed. Thank you so much for, for doing this.

25. 0:19:09

    Okay. Thank you for the correction.

26. 0:19:13

    Okay. Uh, Representative Richardson.

27. 0:19:17

    Yes, ma'am. Uh, I was just wondering, what is the amount that is, is being given now? Do you, do you know by any chance? I, I, hey, I know costs are up for everybody and I, I get it and understand it, but I was just won-

28. 0:19:31

    I didn't bring... Okay, we, E- Ife, can you come forward?

29. 0:19:34

    $280 a month for a family of four.

30. 0:19:37

    Ife, come on.

31. 0:19:44

    Introduce yourself and tell them. Unfortunately, Ife is leaving us for another job.

32. 0:19:51

    Wow.

33. 0:19:51

    But she has also worked hard and on this issue for several years.

34. 0:19:56

    Yes.

35. 0:19:57

    Um, hello. My name is Ife Finch Floyd, Director of Economic Justice at Georgia Budget & Policy Institute, um, for the next few days. Um, but a family of three receives about $280 a month. Um, and like the chair lady said, it has not changed for about 30 years. So it's declined in value by more than half.

36. 0:20:21

    Okay. Representative O'Steen.

37. 0:20:23

    Thank you so much. Did we hear this bill last year? Did you bring this last year? Is this r-

38. 0:20:28

    We did, and had the cash increases at the time, and that's when the department stepped in and said they couldn't afford it.

39. 0:20:39

    I'm just curious, who assigns the value? Is that like a Kelley Blue Book? I mean, who assigns the value of the car? I mean, it says it can't be worth than 46.

40. 0:20:46

    That-

41. 0:20:46

    I mean, is that up to-

42. 0:20:47

    That, that's from the mid-1990s

43. 0:20:51

    Mm-hmm. Th- this program has not been altered since the mid-1990s.

44. 0:20:56

    Okay. Thank you for bringing the bill.

45. 0:20:58

    You're welcome. Thank you.

46. 0:20:59

    Uh, Representative Hilton.

47. 0:21:02

    Thank, thank you, Madam Chair. Uh, many of you know we have a child with special needs, and so he receives, uh, Medicaid, and so we struggle with the same sort of... He's not able to have more than, I think, it's 2,500 in assets in his name. And so what we do to get around that is we create, um, uh, the trust, uh, you know, and, and kind of funnel everything there. I, I'm assuming these families are not doing that. Um, and-

48. 0:21:30

    Yeah.

49. 0:21:30

    Okay.

50. 0:21:30

    I mean, these are very, very poor families.

51. 0:21:32

    Yeah.

52. 0:21:33

    So, um, they're not even kind of at the poverty level. They're well below the poverty level in order to qualify. I mean, you almost have to be completely destitute to access, uh, TANF benefits.

53. 0:21:45

    And then second question, this may be for the auth. I just wanna make sure I'm understanding this correct. So, um, you can have two cars. The second one may not be more than 4,650. Is there a, is there a cap on the primary car?

54. 0:22:02

    Go ahead. Okay. So that's what the legislation would change, 'cause that's the standard actually for the first car now, what's currently in, uh, um, state policy now.

55. 0:22:11

    Okay.

56. 0:22:12

    And it's basically saying, at least let's let people have one car, especially because there is a work requirement, which this bill does not touch, um, in, in TANF. So if we are expecting them to work or if they're grandparents and they're taking, you know, kids to school and things like that, we wanna make sure they can at least, you know, have one car.

57. 0:22:29

    So there's no, so, so there's no equity cap on the first car.

58. 0:22:32

    No. It's if there is a second car, which is highly unlikely-

59. 0:22:35

    Yeah

60. 0:22:36

    ... that's where the cap is.

61. 0:22:36

    So the first car could be $25,000.

62. 0:22:38

    Correct.

63. 0:22:39

    But it, but right now there is a cap on it.

64. 0:22:42

    Correct.

65. 0:22:44

    Okay.

66. 0:22:44

    So right now there is a cap.

67. 0:22:45

    Oh, currently.

68. 0:22:46

    Yeah. Yeah. Okay.

69. 0:22:46

    So it's just to help the-

70. 0:22:48

    So the current cap is 4,650-

71. 0:22:50

    Correct

72. 0:22:50

    ... on the primary car. We're removing that cap and keep, by keeping it on the second car.

73. 0:22:54

    Correct.

74. 0:22:54

    Perfect. Thank you.

75. 0:22:55

    Okay.

76. 0:22:55

    And how did I mix up the only 1,000? I mean, Dr. Allen usually is always right, so where did I get the $2,500? Just let me know for sure and how much-

77. 0:23:05

    She meant the 20 that needs to be-

78. 0:23:07

    Yeah. So it is the 1,000.

79. 0:23:09

    It is 1,000.

80. 0:23:10

    I just wanna tell, I mean, I wanna make sure I'm giving the right information, and somehow... And you just mentioned $2,500, so it must be some other program. I mean, anyway, we'll get it straight. The main thing is it's a pittance. So, you know, for a family that's like that trying to, of three, trying, and lots of them trying to care for a child that's not theirs when they're elderly, and meet those kinds of needs.

81. 0:23:35

    And, and Chair Lady, I hope you're able to, um, allow for at least one more speaker. We have Jamie who represents, um, some of the diaper banks, and she can actually talk specifically about what that car kind of limit actually meant to some of the families that she was, um, been serving.

82. 0:23:50

    We will. Just hold on a second. Stay where you are. Representative Au.

83. 0:23:54

    Yeah, just to underline the impossibility of being able to actually be eligible for TANF, which is temporary assistance for very impoverished families. So the income cutoff is actually so low that it makes it impossible essentially to fulfill both the work requirements, even earning minimum wage, and earn less, right? Because in order to work 30 hours a week, which I understand this is an important, um, you know, priority for this legislature, even making minimum wage, you make too much money to qualify.

84. 0:24:25

    So you can... How, how is it even possible to qualify, right? So I think it's really important. We talk about inflation a lot in this body and how much prices have changed in the past 30 years, but the TANF has not reflected that. So if we want to indeed enable people to lift themselves out of, out of poverty, we have to be able to reflect current numbers-

85. 0:24:45

    Well, I can tell you-

86. 0:24:45

    ... in this program.

87. 0:24:46

    I can tell you that Commissioner Broach was very-- We had a meeting in my office. We-- Very concerned about this, and she realizes it. You know, we had an $80 million hole in that budget, and that is largely due to the increase in the number of children that we have coming into the state's care. More of them are autistic. More of them have really ser- serious behavior problems, and it's costing a lot more.

88. 0:25:21

    It-- They-- We took care of that in the supplemental budget and made that whole, but it is a problem. And so when we were talking, this is why there's no increase of any kind in the cash bases, but trying to help these families in some way by letting them have a car to get around. Ife, who needs to talk? Bring-- Tell her to come up and just tell us who she is and-

89. 0:25:48

    I'll let her introduce herself

90. 0:25:49

    ... and she can... Thank you for helping us out.

91. 0:25:57

    Okay. Uh, good afternoon. I'm Jamie Lackey. I'm the founder and CEO of Helping Mamas. We are a baby-- the largest baby supply and period supply bank here in Georgia. Over the last three years, we've had the privilege of delivering diapers directly to TANF families, um, to their homes. What we're able to deliver these TANF families in diapers is more than the cash value they receive from the state. What I'm telling you is that the cost of diapers have gone up over fifty percent over the last three years, and the cash assistance program, as well as the benefit program, hasn't been touched in, um, nearly thirty years.

92. 0:26:28

    So families don't have a problem, our systems have a problem, and HB 500 is a great first step to helping relieve some of that. We've gone to see mothers who have had to turn their cars in in order to go to rehab in order to qualify for TANF because it was a requirement. I'm not sure how we want families to go to work, take their children to childcare, um, if they don't have an adequate and safe vehicle to do that in. So this is a great first step. We've literally gone to these homes where there are dirt floors that they are living in because, as you so beautifully put it, you have to be le- mer- earning less than minimum wage to qualify for this program.

93. 0:27:05

    Um, again, when the fact that we can give out a full four-month supply of diapers to these families, and it's more than the cash value that they receive in assistance, it's staggering and it's becoming very, very scary and unacceptable for the families that are living that way. We're thrilled with this first step. It's a good first step. We look forward to in coming months, um, in the next year, to work with DFCS to find a resolution that will allow us to in- also increase that cash assistance. But we'd love to improve the system. The families are doing everything they can. We'd like to meet them halfway.

94. 0:27:35

    Are there questions for the presenter? And, and, and Commissioner Brash has told me that she will meet with us and see if there's anything we can do. Representative O'Steen, you had a question?

95. 0:27:46

    I do. Thank you, Madam Chair. Tell me what your name is again and who you're with.

96. 0:27:50

    I'm Jamie Lackey. I'm with Helping Mamas. We are a baby supply and period supply bank here in Georgia.

97. 0:27:55

    Is it, um, is it a nonprofit?

98. 0:27:57

    Yes, ma'am.

99. 0:27:57

    It is. So, uh, I just want to say thank you-

100. 0:28:00

     You're welcome

101. 0:28:00

     ... because there are crowns in heaven for folks like you. Um, it is w- meeting people at the point of their need is important for us to do. So, um, a- at the appropriate time, Madam Chair, I'd like to make a motion.

102. 0:28:15

     One other que- question? Representative Howard.

103. 0:28:17

     Second.

104. 0:28:18

     Oh, you want to second it? Proper time, Representative O'Steen.

105. 0:28:21

     All right.

106. 0:28:21

     You make the motion.

107. 0:28:23

     I'd like to make a motion that we do pass HB 500.

108. 0:28:28

     Okay. I have a motion. I have a second. Representative Howard, got a second, right?

109. 0:28:33

     Second. Second, yes.

110. 0:28:33

     Okay. I have, uh, uh, so we're, the, the status of our bill, is there any further discussion from anybody on the committee about the bill? Okay, seeing none, is there anybody else in the audience that wants to speak to this bill? Okay. Then everyone in the fa- in favor of the substitute to House Bill 500 say aye.

111. 0:28:57

     Aye.

112. 0:28:58

     Anyone opposed, say no. The ayes have it. Okay. Ife, we're gonna miss you. Thank you for all the work that you have done on this issue, and hopefully we can go forward. So all right. Okay. Representative Corpat- well, I mean, have the people that are gonna talk to us about the d- the kiosks, we've put them off. Are you here?

113. 0:29:23

     We can wait though.

114. 0:29:24

     What?

115. 0:29:25

     Go ahead with Senator.

116. 0:29:27

     Okay. All right. Come on. We- we've put 'em off five, four times or something. W- that's why. Come on, Senator. Okay. All right. How about we call up, uh, Senate Bill 395?

117. 0:29:45

     I think Sharon brought it.

118. 0:29:47

     Okay.

119. 0:29:55

     Oh. Got it here?

120. 0:29:56

     395. I have it in my folder. Yep, everybody got it?

121. 0:30:02

     I've got one right here.

122. 0:30:02

     Everybody have it?

123. 0:30:03

     I just want to make sure I have the right-

124. 0:30:07

     I think you have it.

125. 0:30:08

     Oh, this is what-

126. 0:30:09

     That's the whole packet that we got, so you can just ...

127. 0:30:12

     Here you go.

128. 0:30:13

     For you.

129. 0:30:14

     I made four for everybody, so.

130. 0:30:16

     Okay.

131. 0:30:16

     We made five.

132. 0:30:17

     So I want to make sure that it is.

133. 0:30:24

     Thank you, Madam Chair. You want to do 395?

134. 0:30:28

     Yes.

135. 0:30:29

     Okay. Okay, um, let me start by saying that this bill has absolutely nothing to do with Senate Bill 220, which is the bill that Chairman Newton has been working on about, which is a much bigger bill about the medical cannabis program. This is a very specific bill that relates to communication between two of our agencies, and ever since I got down here in 2017, I've been working to try to improve inter-agency communication so that we, uh, don't do things in a redundant way, and we make sure that everybody's got the information they need.

136. 0:31:11

     So the issue here is that DPH processes the applications for people who have been certified for a medical cannabis card. They handle all the administrative part of that. The person who, uh, signs off on the certification is a physician who's licensed through the Composite State Medical Board. And currently, the, uh, since the certifying doctors have to be licensed, the Composite Medical Board needs information in order to make sure that people are in compliance with our law and rules.

137. 0:31:50

     And, uh, so th- uh, what this bill does is basically allows DPH to share de-identified information, subject of course to HIPAA, as everything is, with the medical board so that they can be sure that the people certifying patients for the medical cannabis program are in compliance. That's pretty much it. It's, uh, again, not trying to restrict legitimate patients who are, um, eligible for the program.

138. 0:32:22

     It simply just wants to be sure that everybody's communicating that needs the information.

139. 0:32:29

     Questions for the senator?

140. 0:32:33

     Okay. Please, Richardson. Um, Representative Richardson?

141. 0:32:38

     Yes, ma'am. Uh, can you explain what is, um, out of compliance or in compliance? I mean, if the doctor gives the, the script or the card or whatever, at that point I would assume that they would- be in compliance and that they could move forward, would start using, or, or can you help me on that? And under-

142. 0:33:02

     Well, the patient, the patient's gonna get their card. The department handles that aspect of it. But we've got some out-of-state physicians that are not in compliance. There's one, um, physician in New York, for example, who certified about 4,000 patients, and, uh, the board rules require certain things, like having a relationship with the patient, treating the patient for the condition that they have, and so on. And so, um, we just wanna be sure that Georgia patients are protected by being sure that the physicians are following our law and our board rules.

143. 0:33:41

     So do they need to be a Georgia licensed physician to be in compliance? Is that what-

144. 0:33:48

     They do, but they, uh, they can have a telemedicine license. So in other words, they don't have to be physically located in the state.

145. 0:33:57

     Okay. Okay. Thank you very much.

146. 0:34:03

     Okay. Uh, Representative Hilton.

147. 0:34:06

     Can you, can you-

148. 0:34:06

     Wait, wait, wait, wait. I'm going down the line.

149. 0:34:10

     Oh.

150. 0:34:10

     Representative Hilton.

151. 0:34:10

     Trying to skip me. Look at that. Oh, my gosh. I'm gonna ask a, um, funny question first. Uh, when is crossover?

152. 0:34:22

     When is crossover?

153. 0:34:23

     Yeah.

154. 0:34:24

     Tomorrow.

155. 0:34:25

     And this a Senate bill?

156. 0:34:27

     It is a Senate bill.

157. 0:34:27

     Katie, I'm giving you a hard time. I'm giving you a hard time.

158. 0:34:29

     But, um-

159. 0:34:29

     I'm giving you a hard time

160. 0:34:30

     ... to my friend from the House, um, I'm very thankful that the House is trying to move positive legislation forward regardless of the time of the session.

161. 0:34:41

     Love it. Love it.

162. 0:34:42

     Thank you. I, I think that's a question you should ask me-

163. 0:34:44

     That's-

164. 0:34:44

     ... 'cause I'm the one who sets the agenda. But I'm tired of everything coming at the end.

165. 0:34:50

     I love it.

166. 0:34:50

     So I thought I would try to get something over so we could, even if we just vote on two or three bills a day so they're not all piled up on the end.

167. 0:34:58

     Hopefully this will grease the skids. A serious question, um, a- and a couple. So it's, it's really that one line there. The board, I assume, is DPH.

168. 0:35:08

     No, the board is the, um, medical board. It just adds the medical board to the entities that are by law allowed to get the information.

169. 0:35:17

     Okay. I, and the reason I'm poking at this is, this has been, uh, I just don't feel like we're getting stuff to the right people. You know, it, it's been kind of a mess since inception, and so I worry about kind of any new legislation making it any more complicated than it already is, you know?

170. 0:35:32

     This actually should make it simpler than it is now, because the, uh, people who are accountable for enforcing our law don't have a data-sharing agreement for this with the Department of Public Health. And so this is simply making sure that they can share information, obviously not specific patients, but de-identified data.

171. 0:35:56

     So are they not already sharing that information?

172. 0:35:57

     No.

173. 0:35:58

     Okay. What about out-of-state doctors? Can you speak to them, that maybe have a license here? How does that come into play?

174. 0:36:04

     They, the out-of-state doctors, um, and our director of the medical board is, is sitting here, Jason Jones, if you have specific questions about that. But, uh, they do have to have a Georgia license, but they don't necessarily have to be here. But I'm sure you've seen some of the things that are happening on the internet with people, um, with websites where for money they will guarantee to certify you within a day or 15 minutes or whatever.

175. 0:36:35

     And so we just wanna be sure that the people that are doing the certifying are actually, um, following our state laws.

176. 0:36:44

     Okay. Thank you.

177. 0:36:46

     Um, you, one of the reasons is the only boar- uh, the only doctors that the board can discipline, you know, if they're doing something wrong, are doctors that have a license in Georgia. I mean-

178. 0:37:00

     Correct.

179. 0:37:01

     Right. So that's why they need to be, and why they need that information, because they are responsible for making sure the person, the doctors doing this are doing it the right way, and so that's why, with the problem with the internet and all.

180. 0:37:17

     Mm.

181. 0:37:17

     Then they ... I hope I didn't confuse that. Okay. Representative O'Steen.

182. 0:37:20

     Thank you. Thank you, Chair. I didn't mean to skip my, my friend. Tell me this: How many doctors in Georgia are currently dispensing doctors? Do we know that? That are physically housed in Georgia, that have a physical location in Georgia.

183. 0:37:39

     Uh, I'm gonna have to dig through some of these papers here to find that, but I don't know. DPH, do you guys have that handy?

184. 0:37:49

     Uh, can I go forward with that?

185. 0:37:51

     Can I-

186. 0:37:51

     Yeah. Come on. Yeah, come on

187. 0:37:52

     ... uh, can I ask, uh, Megan to come up here?

188. 0:37:54

     I'll have a follow-up question, Chair, when we, when we have that.

189. 0:38:04

     Hey, everyone. I'm Megan Andrews with the Department of Public Health. Um, pretty consistently w- about 30% of our registry has out-of-state physicians, are certifying about 30% of the patients. So, um, there's roughly 35,000 almost on the registry right now, patients.

190. 0:38:25

     How many physicians do we have in Georgia that are ... A- and what kind of qualification do you have to have? Is there some kind of certification that you have to be able to, as a physician you just can prescribe?

191. 0:38:37

     Mm-hmm. Mm-hmm.

192. 0:38:38

     Okay. How many of, of those in Georgia do that? Do we know? Do we have a idea of how many of our physicians that are housed in Georgia-

193. 0:38:46

     Yes

194. 0:38:47

     ... that have a physical location here?

195. 0:38:48

     Megan?

196. 0:38:49

     All right. Didn't you say we have about 35,000 physicians?

197. 0:38:52

     35,000 patients.

198. 0:38:53

     Patients. What?

199. 0:38:54

     Patients. Patients.

200. 0:38:56

     Patients.

201. 0:38:56

     Patients. And about 30% of them

202. 0:38:59

     are registered by out-of-state physicians. Um, and the data I have is from January, so it's a little bit out of date. But the, um, the number of active out-of-state providers that we have are 26. Wait a minute. How many ... You come up to ... How many physicians overall in the State of Georgia?

203. 0:39:25

     So the last figure was, um, total physicians were

204. 0:39:35

     698. What? Total physicians. So the out-of-state physicians are, what, the 20- 26 26. Okay. So- Okay ... Georgia physicians would be, what was that? Six, um, 70 some odd. Six- 70 ... 670 Georgia physicians. Georgia physicians that are in Georgia by our state. That are in state are prescribing. Prescribing. Are prescribing. And the other out of state would be the telemedicine doctors that are, um, just strictly telemedicine. Do, do our, do our in-state physicians use telemedicine?

205. 0:40:08

     Some do. Some do. Some do. So my question is, why, why is there a need for out-of-state physicians to do this in Georgia? There isn't. That's my, that's my question. So- That's actually a great question. Um, and first, I thought about just not having out-of-state physicians do it, but it's arguable whether we have enough people around the state that are doing this certification for patients.

206. 0:40:40

     And the other thing is sometimes people do go, college students, for example, who are out of state. Um, so there are scenarios that you can come up with where an out-of-state physician might be, might add something to the program. So that is why we didn't just eliminate the out-of-state physicians from being able to certify patients. And also, we have, um, uh, you know, there's a demand. I don't know what the demand is gonna be in the future, but whether we have enough Georgia physicians to meet the need, I don't think we have good data on that.

207. 0:41:16

     And I think we'll have better data on it once we get everybody sharing the information that they- Gotcha ... need to be sharing. You, you, you understood where my circle- Yes ... of questions went. Yes. Thank you so much. When you talk about, when you talk about the out-of-state physicians, we're talking about out-of-state physicians that are licensed in the State of Georgia also? Exactly. Okay. So just so that if they're doing something and saying, giving, I don't know what, d- when they really don't need it, or just anybody that asks, they can, we can discipline them it, through the board.

208. 0:41:47

     Okay. Uh, Representative Frye. Thank you, Madam Chair. Um, thank you for bringing the bill. Appreciate this, uh, efficiency. I just have a couple questions. I'm trying to get my head around how this operates, so if, if you'd just bear with me. Um, on the line, so on line 26, it says, "To the board," and that is, should be defined, I guess, as the current, uh, Composite Medical Board, right? Yes. Um, what would another state licensing board

209. 0:42:24

     be that the rest of the line essentially defines without defining? What is, what is another state licensing board that we would give authority to based on this legislation?

210. 0:42:45

     Uh, uh, today, as of right now, it's just the medical board. I don't know what's gonna happen down the road with which providers can do what and who can sign off on what. So this would cover that in case we add providers who can certify patients. Um, follow-up, ma'am. So w- and could you clarify that? What do you mean by providers that ... Would it be, like, um, if we start allowing ... And these are friendly questions. I'm really trying to get my head around this.

211. 0:43:16

     So if we start allowing curb market sales of whatever, right? So dispensaries at curb markets. So would that be whoever licenses the, the corner retailers? I'm, I'm just trying to figure out who besides the Medical Composite Board do we even need to have, and that is a very broad description. Probably just nursing.

212. 0:43:41

     Nursing. Pharmacy board. Pharmacy board. You were saying? Yeah, GDNA, Pharmacy Board. Do you want to speak to that? You would? Sure. Um, the other boards that may be involved is the Board of Pharmacy. There was a point in time in which pharmacies were supposed to be able to dispense. I don't know what happened federally with that. But, um, and then the Board of Nursing, nurses operate under protocol agreement and may be working with a physician, um, in overseeing patient care.

213. 0:44:12

     They're not authorized to certify directly into our system right now 'cause they're not a physician, but they may be overseeing patient care and help with, um, medical records and things like that.

214. 0:44:27

     So again, I th- I feel like, okay, here's a, here's a question that would answer my question. Um, do we do this already for the other, for any other medication? So, like, you know, considering that this is being medicinally utilized, right? Mm-hmm. So if we're doing, say, um, I can't even think of another medication, but, you know. What if you had to put- This is, this is actually a very unique program that was created, as you know, years ago, and it has its own, m- it's a different animal than anything else we deal with in healthcare because it's, goes through a, uh, the, the rules go through a commission.

215. 0:45:12

     And, um-

216. 0:45:14

     So we don't handle any other medication this way that I'm aware of.

217. 0:45:19

     Okay, thank you for the answer to that. Um, and is this, could this be, and, and I'm not a doctor, does the HIPAA, the HIPAA regulations prevent this information from being shared with law enforcement? Just a random question.

218. 0:45:34

     Uh, no. So-

219. 0:45:35

     Go ahead.

220. 0:45:36

     Sorry. So the Georgia Medical Board is considered a health oversight agency by HHS-

221. 0:45:40

     Mm-hmm

222. 0:45:41

     ... so we can share that information amongst agencies, uh-

223. 0:45:43

     Okay

224. 0:45:43

     ... for investigative purposes.

225. 0:45:45

     Okay, for investigative purposes. So you already ha- Excuse me. Follow-up. So the Georgia Medical Composite Board already has the authorities to share this information with whomever they feel is appropriate for an investigative purpose.

226. 0:45:57

     For an investigative purpose, yes, sir.

227. 0:45:59

     Okay. Um, and Representative O'Steen answered my other question about the amount of doctors. I am concerned with the out-of-state doctors, et cetera, et cetera. I think that's an extremely important point to bring up. Thank you for that. Um,

228. 0:46:16

     in light of such a broad phrase, and I've been around long enough to understand that you can take a phrase like this and, and apply it in ways that we c- may not be able to fathom right now. Um, I would feel more comfortable with the legislation if we strike after the word board, add a period, and strike the rest of the phrase. And I believe that we would be able to simplify the bill even further and achieve the same goals that we're trying to achieve right here with this legislation, without an over-broad terminology describing a group that we don't even know or can think of right now.

229. 0:47:04

     Well, I think we did come up with some other examples of, you know, for example, a nurse who's operating under a protocol, a physician protocol, the board of nursing might come into play. So that's just an example of another board that might need information about, um, you know, if, if this is the specific thing that they're doing.

230. 0:47:27

     And-

231. 0:47:28

     So... Go ahead.

232. 0:47:29

     And I, and I can speak on what the, our medical board would do in a situation like this. So any investigative material, complaint material is considered confidential, so we don't release it just to anybody.

233. 0:47:40

     Sure.

234. 0:47:40

     So we have to go to the board. We discuss it. We say, "Okay, we can release it or not." So this is just saying that if the nursing board is in the s- same situation as we are right now, where we can't share information, that now we can share that information if deemed appropriate by the board. So, um, there's safety, safety measures in the back end that we do to make sure that this doesn't just go to the used car, um, board and, and things of that nature. So we'll, we'll, we have those safety measures already in place, um, so we don't give that information out without that, uh, due process.

235. 0:48:13

     Thank you for that clarification. And Madam Chair, follow-up, if I may. Um, I really feel like there has to be a hard list of agencies that we can come up with right now that need to have this information, like the nursing b- like I would guess any medical, anybody who has to do with prescribing, um, or-

236. 0:48:36

     Pharmacy

237. 0:48:36

     ... working under, you know-

238. 0:48:37

     The pharmacy board would be another example.

239. 0:48:39

     Yes, ma'am. Madam Chair?

240. 0:48:44

     Yes.

241. 0:48:44

     She, she's gonna-

242. 0:48:46

     Yeah.

243. 0:48:46

     Yeah, yeah, sir. Yes, sir.

244. 0:48:47

     Sorry, Mr. Chair.

245. 0:48:48

     Yes, sir, Representative.

246. 0:48:49

     Um, I just wanna see if we can, uh, I'd like to see if we can create a hard list rather than leave this definition ambiguous. Just based on my previous experience with the way we've crafted laws down here, I think it's im- it would be important and compelling to get this right, hit it right on the head.

247. 0:49:10

     Yes.

248. 0:49:11

     I, I agree with you. I'm gonna take another couple of questions, and we may look at a way to try and handle that.

249. 0:49:17

     Thank you, sir.

250. 0:49:19

     Number 16.

251. 0:49:20

     So let's just take that out.

252. 0:49:22

     Thank you for your answers.

253. 0:49:23

     Yes, ma'am.

254. 0:49:24

     Thank, thank you, Mr. Chairman. And Senator, uh, these are friendly questions because I don't really un- understand this. So, uh, I'm thinking about how many physicians total in the state are there that could possibly do this?

255. 0:49:47

     Any physician in the state could certify a patient for the program.

256. 0:49:53

     But right now only, so there's thousands of physicians, but right now less than 1,000 are certifying these, these patients. Um-

257. 0:50:01

     That's correct.

258. 0:50:03

     And only 26 of them are from out of state. So are we trying to address, I, I can't figure out what we're trying to address here. Is it the telemedicine part? Uh, is it, are, are we concerned that people online are, are like giving cards to Georgia residents? I don't, I don't get this part.

259. 0:50:27

     Uh, the, the concern is that we have two different agencies that are handling different pieces of the process, and it's like the blind man and the elephant right now. The Department of Public Health is handling all the administrative part. They're getting the application from the certifying physician, and they're dispensing the card to the patient, but the medical board doesn't really get that information from them about who's involved with the program.

260. 0:50:57

     But they're a physician though, right? I mean, they're already a physician. They can't just-

261. 0:51:00

     They're a physician, but the medical board doesn't know how many physicians are certifying patients for, for the program or who they are. And so, uh, it- It sort of hamstrings the medical board in doing their job, which is to be sure that the physicians who are involved in the program are doing the right thing for the patients.

262. 0:51:29

     Okay. C- Can I follow up with two more questions? Again, just seeking to understand this. Um, does this impact a compact agreement that we may have with another state?

263. 0:51:42

     No. It's-

264. 0:51:48

     O-

265. 0:51:49

     I think that might be...

266. 0:51:50

     Let me see that. No, it doesn't impact the compact agreements.

267. 0:51:55

     Okay. And my last question-

268. 0:51:58

     We're talking about physicians that have a telemedicine license, not physicians who are licensed through the interstate compact.

269. 0:52:05

     Okay. How-

270. 0:52:06

     So, so the medical board is the compliance arm of the-

271. 0:52:11

     Gotcha

272. 0:52:12

     ... of the program, and yet they're limited in their ability to know what's going on with the program because they don't have a data-sharing agreement with the Department of Public Health.

273. 0:52:23

     Okay.

274. 0:52:23

     That's all the bill's about.

275. 0:52:25

     Okay, gotcha.

276. 0:52:26

     Yeah.

277. 0:52:26

     Okay. Can I just ask one more question just for my own edification?

278. 0:52:32

     Yes, ma'am. I think there's a lot of clarity trying to be gotten here, so yes.

279. 0:52:38

     Uh, what, what would if... What would they be disciplined for?

280. 0:52:46

     Well, they have rules about what they're supposed to do if they're participating in the program. They're supposed to have a relationship with the patient. They're supposed to be treating them for the phys- for the condition that's on our list of conditions, and they're supposed to be providing a report to the department, which actually was originally intended to go to the board, but that's not how it ended up in the law, and, uh, that's not happening in a lot of cases.

281. 0:53:17

     The reporting that's supposed to come back is, I think we decided it was 54% or some, some number like that. I can, I can pull it up. But, uh, there's a l- th- there's a lot going on out there that is not in line with what our, uh, board rules require.

282. 0:53:40

     Thank you.

283. 0:53:41

     Um, I think next up's, uh, Representative Hilton.

284. 0:53:46

     Thank you, Madam Chairman. Um,

285. 0:53:52

     um, I... A good mentor of mine has, has told me when you're looking at a bill, kind of look at the, everything that's in that code. I know this bill online picks up to subsection F, and so I just kind of Googled the code section here. If I, if you go back, and I'm, I'm sorry, because you don't have it in front of you, but subsection E right before this says the board, and the board is defined as the c- Composite Medical Board, the board shall require physicians to issue semi-annual reports to the board. Such reports shall include physicians to provide information regarding dosages, particular condition, patient concerns.

286. 0:54:26

     So I mean, does that section not address what we're trying to accomplish here?

287. 0:54:30

     It, it addresses it, but it's not happening, and that's partially because the reports are currently going to the Department of Public Health. They're not going to the medical board, and that's the way it was set up a long time ago.

288. 0:54:44

     So it's in law that it's supposed to go to the medical board.

289. 0:54:47

     Yeah.

290. 0:54:47

     But if we put it in law again, yeah.

291. 0:54:48

     You can try to resent-

292. 0:54:49

     Can I add something?

293. 0:54:50

     Yeah, please.

294. 0:54:50

     Yes. Um, so we, a few years ago, we were going through statute to make sure we were in compliance with everything and, you know, discovered we were out of compliance with requiring these semi-annual reports. At the time, I think Jason hadn't even started yet. Um, and so the Composite Board didn't have the IT infrastructure at the time to be collecting these semi-annual reports. The physicians are used to going into the public health system-

295. 0:55:16

     Mm-hmm

296. 0:55:16

     ... and reporting that data, um, like certifying their patients through our IT system. So we collect the semi-annual reports on behalf of the board in our IT system, the same place where they go certify the patients. Um, the issue is the-

297. 0:55:35

     So then-

298. 0:55:35

     ... subsection-

299. 0:55:36

     Should twen- just line 26 then say to the board or DPH? I mean, is that... Is DPH wanting this information?

300. 0:55:44

     We don't necessarily need it, but to be a good partner and, um, very limited resources in this program, we set that reporting structure up in our system. So we could p- both be in compliance with law and, you know, share information, um, as those reports come in. The problem is, is that subsection F creates very strict confidentiality provisions around enrollment of patients into the program, not necessarily the same semi-annual reporting.

301. 0:56:17

     Um, that language is even stricter than HIPAA. It has a laundry list of three, three situations in which we can share data out of the system.

302. 0:56:27

     Okay.

303. 0:56:27

     Um, and we've run into this issue with even trying to share data with the Cannabis Commission that you all created. Um, so this is just adding the board as an authorized recipient of the information out of the registry itself, not necessarily the semi-annual report.

304. 0:56:44

     Seems like the gentleman wants to... Yeah.

305. 0:56:46

     Yeah, go ahead, Buddy.

306. 0:56:47

     Um, so it is information that we should be getting, that we do need in order to, to maintain compliance in this, uh, uh, in this, uh, arena with out-of-state, uh, physicians. We don't get the information to show, um, who the patient is and, and what we need to do, uh, in order to maintain compliance and make sure that patient's safe. That's, that's our ultimate goal is to make sure patient safety is here, and without that information, we can't maintain compliance in that with the physicians. So that's, this, that's the whole reason for this.

307. 0:57:20

     Uh, we are supposed to get that semi-annual report, but like she said, we, uh, didn't have the infrastructure at the time, and I took over two years ago.

308. 0:57:28

     Mm-hmm.

309. 0:57:29

     Um, so we're, we're trying to build that infrastructure. So we're, we're moving towards that. We just need to get the information so that we can start the compliance process.

310. 0:57:38

     Okay. Mr. Chairman, I, I know we've had a pretty robust conversation here, and I think it's been good. Um, if it's okay with you, I'd, I'd like to make a motion that we maybe table it for right now. I know we've got plenty of time since we are pre-crossover to pick this back up and, and we can kind of work with the author on perfecting it even more. I think now's the appropriate time of it.

311. 0:58:01

     I have one.

312. 0:58:01

     Uh-

313. 0:58:01

     One comment.

314. 0:58:04

     Yes, number nine.

315. 0:58:10

     Just in response to the motion, I'm gonna introduce a different viewpoint. This seems like a pretty straightforward bill. What we have here is we have a program that we want to deliver for patients, and we have an information system where two systems are siloed away from each other, and we're trying to make it more effective that they can communicate with each other under how the Medical Licensing Board works to make sure that Georgia licensed physicians can get care to their patients in a way that is more efficient.

316. 0:58:40

     I personally don't see a problem with that. I'm actually surprised at the amount of discussion we're having about the concept of this bill, and I would, um, disagree to table this bill 'cause I think it's important for us to do this.

317. 0:58:54

     Uh, number 26, Representative O'Steen.

318. 0:58:57

     Thank you. Thank you, Madam Chair. It just addresses two things. We're trying to address making sure that our, we, we know what the physicians are prescribing, and we're trying to protect our patients, right? That's the t- that's the two things that we're trying to do with the bill, and that's it, correct?

319. 0:59:18

     Yeah, we're just trying to fix a big hole in the communication between two state agencies that both need the information and currently can't share it. That is all the bill is trying to do.

320. 0:59:28

     There's just a gap in communication.

321. 0:59:30

     And I was just thinking about your question earlier. There could be a situation where the board would need information from another state agency like the nursing board or the pharmacy board, or I'm not even sure that you could envision all the scenarios that might come up with information that they would need to get from another board. And so, um, the, this allows the Department of Public Health to give the, primarily the medical boarders who we're concerned about, um, the information that they need to just enforce our law and their board rules.

322. 1:00:14

     Uh, we have a motion on the floor. Do we have a second?

323. 1:00:18

     Second.

324. 1:00:20

     Okay. Any discussion on that? All in favor say aye.

325. 1:00:27

     Second.

326. 1:00:28

     Yes. All in favor say aye.

327. 1:00:31

     Aye.

328. 1:00:32

     All opposed?

329. 1:00:33

     No.

330. 1:00:33

     No.

331. 1:00:36

     No.

332. 1:00:36

     It's a hand count, basically.

333. 1:00:38

     Um, can we get a hand, hand count on the motion to table?

334. 1:00:43

     Yes.

335. 1:00:45

     What do we have, four?

336. 1:00:50

     Excuse me. I must be excused.

337. 1:00:53

     We lost our quorum.

338. 1:00:54

     What? We lost our quorum.

339. 1:01:02

     So, um...

340. 1:01:07

     They thought that was complicated. Well, we'll see, I guess. They don't have a quorum anymore.

341. 1:01:12

     Senator, can, can, uh, I ask you to allow us to move the presentation, and if you would wait for your second bill, maybe we can have a, get a quorum back?

342. 1:01:26

     Uh, sure. And if you think this bill's complicated, just wait till you see the next one. It's an agency bill. So, um, I don't know how much time you got, but, uh-

343. 1:01:35

     Go ahead

344. 1:01:35

     ... I'm prepared to tell you all the details.

345. 1:01:39

     We can hear. He's-

346. 1:01:39

     Thank you.

347. 1:01:41

     I can't hear that. I just-

348. 1:01:41

     Okay. So we're not going anywhere. We're gonna let, we're gonna let them do their presentation.

349. 1:01:48

     Can, can I get you to come forward to give your presentation, please? State your name.

350. 1:01:54

     Yes. This is David Newton.

351. 1:01:55

     Yes, sir. Thank you.

352. 1:01:56

     Thank you, Mr. Chair, and thank you for the committee for allowing me to come here. I, I know it's been, uh, a couple of times that we tried to get here, but I do appreciate the opportunity here. So my name's David Newton. I'm a paramedic. I work in the state of Georgia. I also used to work with Megan over at DPH, and so I've been there for a while. So public health is near and dear to my heart. And so forgive me for those of you who have heard this presentation before, uh, but I wanna talk to you today about our Test and Go Healthcare Kiosks. So our healthcare kiosks, this is something that, uh, was born during COVID. It was actually born here in the state of Georgia as a way to provide, uh, back then, COVID testing to areas that couldn't support a staff site 24/7.

353. 1:02:33

     And so this was put there so that even at 3:00 in the morning in a rural area, someone could come and get a COVID test, a PCR COVID test, and get it resulted, and so that way they could get treatment if they needed it. But it's been much more broad than that. Uh, it started out during COVID, but it's also about things like harm reduction, so things like, uh, providing naloxone for overdose reversal. Also, STI testing, and now we have chronic disease testing as well. So this is about healthcare access and about providing this. And as you see some of the quotes, and I know you've all got the handouts here, but when we talk to some of our current partners, our current public health departments and tribal health departments, what they see this as is an ex- extension of their care system.

354. 1:03:14

     And so as one of our, uh, partners said, she's like, "You know, so much of public health does not occur between, you know, business hours, basically." And so this was a way that they can provide tools outside of those business hours for the community that they serve. And so when you look at time, distance, privacy, and convenience, this is about providing that for patients who may not be able to get to the health department or to a clinic during business hours. And so allowing them to do it at the time that they wanna do it, 3:00 in the morning, 4:00, whatever, that's what one thing that COVID taught us, is people want the care, they want the testing, but they wanna do it on their own schedule, and they wanna do it when they have that available time.

355. 1:03:52

     And so this is what our tool is designed to address, is those gaps that exist just based on someone not being able to physically get there. When you put small barriers into place, right, people, they stop doing, they stop either getting tested or they don't ever get tested. And so that's what we're trying to do, is to remove those barriers. And so we have kind of a three-pronged approach or three main, um, kinda things that we address, and that's overdose, and so that's with, uh, the naloxone and other tools. Um, we also have STI testing, and so these are self-collected test kits that patients can get out of the kiosk, again, at any time of day.

356. 1:04:28

     And we have both rapid tests that the patient can result, and you've probably seen those before, but we also have self-collected test kits that actually go back to a lab. So the patient can do all of the gathering of the specimen themselves, send it back to a lab, and they get a full lab report. With rapid tests, DPH does not get any of that data. All they can see who's, who's gotten the test kit, but they don't get any results of that. So if it is a reportable disease, th- there's nothing to report 'cause the patient looked at it themselves. By sending it off to a lab, even though it's self-collected, they can still get all of that data.

357. 1:05:00

     Um, and then chronic disease testing. This is another component of this where, you know, again, small barriers that prevent someone from getting a hemoglobin A1C to see if they're pre-diabetic, from someone, you know, getting a cholesterol test to see if they, you know, if they need to be on meds or they need to do a diet modification. It's all about getting that access, getting that testing to them, uh, when we can so that we, we do address that. And so I'm gonna kind of tell you a little story about Jim, and this is just a hypothetical situation of someone who's working in a warehouse in a rural area in Georgia.

358. 1:05:32

     He's feeling tired, he's feeling thirsty, and he's just not, not feeling himself, and he just attributes it to age. And I think we all know that this is something more than that. And so when he finds a kiosk in his area that's offering this testing during the times that he can go to it, and in a private manner where he doesn't have to go to the clinic first, he can make this first step at the kiosk. So he gets tested, finds out his hemoglobin A1C is high, and then he actually gets connected to care. So it's that first step of getting that testing that we're able to address with this.

359. 1:06:02

     And this is just one story of a chronic disease, but imagine this with STI testing, about someone who never wants to come into a clinic to answer those awkward questions, about someone who needs to get tested but is not getting tested because, again, they're, they're afraid of that stigma. And so having this testing where they can get it at any time of day and yet still get lab results from that and then get connected to care afterwards, it's kind of a game changer. And we can identify cases that we would have not otherwise been able to identify.

360. 1:06:33

     And so this is kind of our tool. This is just a picture. This is, uh, from one of the ones that we had at DPH, um, under the COVID, um, uh, dollars there. But no staffing. This is indoors or outdoors, so this does not have to be bound by the hours of a building. This can be twenty four/seven, and that's the goal of it, right, is to increase that access. And so most of our kiosks across the country are actually outdoors, um, so that they can provide that. And it's turnkey. This is not something that if we were to partner with the health department or with state DPH and put them at the health departments, this is not something that their staff has to go and stock or restock or monitor the temperature inside.

361. 1:07:07

     We're handling all of that for them. This is a turnkey service that allows them to... They tell us where to put it, they tell us what to put in there, and then they start collecting the data from it, and they're serving their community, again, in a very accessible way. And it's adaptable. It doesn't have to be just one thing that it addresses. It could be harm reduction. It could be respiratory testing, so COVID, flu, and RSV, the STI, the wellness testing, all of that, overdose reversal, even general health items. We'll see colleges put in things like Tylenol and Motrin and cough drops and eye drops. So it's very adaptable to the needs of that community and the needs of the area.

362. 1:07:41

     And it can be seasonal as well so that if cold and flu season's approaching, you, we start putting more cold and flu tests, or, you know, COVID and flu tests in there. So, uh, very adaptable, uh, on that. And it's really designed to provide that care and that testing where someone lives, works, and plays, right? So it's not about just putting out a brick-and-mortar site. This is about expanding that, not replacing it. We are not trying to replace health departments. We're not trying to replace clinics. We're trying to expand the access and the, the, the, the system or the area that they can cover, uh, with this.

363. 1:08:13

     And think about for employers, too, if you're keeping someone healthy and getting them care sooner rather than later, then that's a, a benefit for employers as well. And it's flexible, right? In case there's another pandemic, which I hope is after all of us retire, right, is that all we have to do is come change the test kits out, and then now you have a twenty four/seven testing site for that outbreak. And so we're able to adapt pretty quickly on that. And so a practical step, right, build on Georgia's experience. Georgia has had the most kiosks of any state. Uh, it was 80 at one point at the height of this.

364. 1:08:46

     So the map that you see right there is actually where all of the dispenses occurred, not just where the kiosks were, but the larger circles are where more of the dispenses occurred. And so we've already seen this in Georgia. It's already proven, uh, to be beneficial. It's already proven, you know, we had over 15,000 dispenses during that time, so it's a lot. And we've seen this again in other states looking at other conditions besides just respiratory. Um, and partnering, again, with existing providers. It's not about replacing anyone. This is not about taking away business from an FQHC or a rural hospital.

365. 1:09:16

     It's actually about expanding their footprint, uh, for that. And it's cost-effective, right? I mean, think about finding, uh, an STI case that you never would have found before or finding someone that does need, you know, the, the medication for diabetes or for, you know, high cholesterol, finding that sooner rather than later so that they don't have that sequela from long-term, uh, stuff on that. So it's, it's all about that. And, you know, think about the Rural Health Transformation Program. I'm sure you're all familiar with that, that that is another avenue that could be part of this is, you know, using that to, again, expand the, the access of FQHCs and hospitals.

366. 1:09:50

     And that was all. And I thank you all for your time, and I'll take any questions.

367. 1:09:54

     So this is a vending machine type thing, and you charge for different tests-

368. 1:09:59

     Mm-hmm

369. 1:09:59

     ... different amounts or whatever. And as soon as, obviously, one runs out, that's probably the, the one that's getting the most calls.

370. 1:10:06

     Mm-hmm.

371. 1:10:07

     You would have somebody come and restock.

372. 1:10:09

     Yeah, and we try to not wait until it gets that low.

373. 1:10:11

     Sure.

374. 1:10:11

     We always, you know, monitor that, 'cause we monitor all of it remotely.

375. 1:10:14

     Sure.

376. 1:10:15

     And a lot of our health departments actually do everything for free that's in there. Colleges will sometimes charge. Our tribal ones, they'll, you know, they'll do most everything for free. They can also limit. So, like, one of our health departments, they say, you know, "We don't want someone to come and clean us out of naloxone," so they set up a limit that one person can get two free per month. And we're, we're able to set up any limits like that and collect any data. I used to say this at DPH all the time, right? No data, no dollars. So collecting all of that data about who you're serving and about, you know, what... Like, why are you getting naloxone? "Well, I have a family member." You know, whatever data you wanna collect can go in there as well.

377. 1:10:48

     And yes, we monitor all of that stocking so that you're not gonna, at 3:00 in the morning, when you g- when someone goes to get something, it's not gonna be missing.

378. 1:10:55

     Sure.

379. 1:10:56

     So.

380. 1:10:56

     All right. Any other questions?

381. 1:11:01

     Thank you very much-

382. 1:11:01

     All right

383. 1:11:02

     ... for your presentation.

384. 1:11:02

     Thanks for your time.

385. 1:11:03

     We appreciate it.

386. 1:11:04

     Thanks.

387. 1:11:06

     One, two, three.

388. 1:11:10

     We're one short.

389. 1:11:12

     Why don't we take a brief recess?

390. 1:11:19

     Senator, we're gonna t- try and, uh, take a brief recess and see if we can get somebody here. We need, we need, we need one person, uh, so we can-

391. 1:11:30

     I'm happy to present the bill even if you don't have a quorum to vote on it today, but whatever you want us to do. I'll send-

392. 1:11:39

     Okay.

393. 1:11:45

     I've got time if you need to break.

394. 1:11:54

     If you'd like to go ahead and start pr- your presentation, we'll be glad to take that.

395. 1:12:04

     And I agree, this is a thick bill.

396. 1:12:08

     I'm gonna bring my friend Megan Andrews from DPH with me again.

397. 1:12:17

     So this bill is an agency bill, and it is a cleanup bill. And what it does is removes obsolete or unused code sections and updates the statutes to match the operations that the department has. It does not create any new programs, expand any regulatory authority, or change any benefits that people are receiving. Technically, today, DPH is out of compliance with multiple code sections tied to advisory committees or programs that no longer exist.

398. 1:12:54

     So by cleaning up these provisions, it improves transparency by aligning the law with their current operations, reduces confusion, and frees staff time from fulfilling outdated mandates. So the major categories of changes are outdated marriage-related health requirements. The department is, under our law, required to, uh, distribute a marriage manual, which was put in place in 1973.

399. 1:13:25

     They also, um, were, are required to produce brochures for certain things like, um, test sites for HIV and AIDS, sickle cell testing, and things that are currently available on the website are no longer distributed by brochures. Um, another thing that it does, it eliminates several dormant boards, commissions, and positions. The, um, you're probably all familiar with the PDMP, the physician, um...

400. 1:13:57

     I forgot what the acronym stands for. Drug Monitoring Program. Yeah. The, the prescription- Yeah ... um, program that's in place. That advisory committee for that's no longer needed. The program's been up and running for a number of years, so we don't need an advisory committee. The Cancer Advisory Committee and Cancer Control Officer, that's been in code since the '80s. The committee does not exist, and the position's been vacant for years. The, uh, commission, the postnatal tissue and cord blood, there haven't been any appointments since 2008.

401. 1:14:30

     And, um, then there are chronic disease programs that are unfunded or not operational. Like, for, um, osteoporosis and arthritis, we established those programs, but we never funded those or implemented them. Also, another thing the bill does is it aligns the statute with current active operations. For example, the home visiting pilot that we put in place previously for, uh, pregnancy, that is now a, uh, permanent DPH service.

402. 1:15:00

     It's not a pilot anymore, so that language needs to be updated. Um, there are a few others in that category. Newborn hearing screening, it removes an advisory committee that's been eliminated. Neonatal abstinence syndrome, they, uh, it keeps them from having to do an annual report that they don't have the expertise to do in-house. That really is, uh, more on the DBHDD side. And then, um, home-delivered meals, et cetera, for older adults and preschool special needs children, that actually should be, um, DPH, not DCH in the law.

403. 1:15:47

     And then w- there are several other, uh, reporting and unfunded mandates that this addresses. For example, EpiPen. The current law requires that when EpiPen is used, every administration has to be reported to DPH. Well, that's clearly not even practical, much less needed. Stroke centers and emergency cardiac care center grants, those, uh, it keeps the grant programs on the books, but it clarifies that those programs are subject to appropriation so that they don't have to file zero activity reports in years that there's no activity.

404. 1:16:25

     It modernizes the Georgia Volunteer Health Care Program report to, um, update the committee name to match the House and Senate committee names. And, uh, so that's basically what it does, and I'm happy to provide more detail, or Ms. Andrews is able to do that on any of the things if you have questions. But bottom line, this does not cause any Georgians to lose services, it does not shut down any active funded programs, and it just cleans up the code so that it matches current operations of the department.

405. 1:16:59

     With that, I'd be happy to take questions. I do have one question. How many of the, um, services are, are not unfunded? You were saying a lot of them are, are not funded. Do you know how many of them are, are not? Are not? Yes, ma'am. Um- And, and are we still- I didn't, I didn't get- ... are we still trying to get funding for some, are we? No, a lot of these things, we passed them 30 years ago or longer, and, uh, it was somebody's pet project and never had any appropriations and, uh, were never formed.

406. 1:17:35

     And so they're just, um, causing reports to have to be filed that really haven't been active for many years. Yes, ma'am. I didn't add them up, though, but there's a bunch of them- Yeah, yeah ... in this bill. You can see- ... every little pink sticky I have on here is one, so I could just count those. Okay. Uh, Representative Hilton. Thank you, Mr. Chairman. Um, I love seeing a bill that has more strike-throughs than underline. This may be my favorite bill of the session.

407. 1:18:05

     Um, and at the appropriate time, I will make a motion do pass, because I believe we have a member who is a few seconds away from coming in, so

408. 1:18:17

     at the appropriate time.

409. 1:18:21

     I'll second that motion. Yeah, this is what we call, um, on our side, a red tape rollback bill, which is just cleaning up and streamlining our state government. I certainly appreciate you doing that, for sure. So if we'll, um, we'll wait just a second and we'll get that member in here and we'll take a vote.

410. 1:18:49

     Should we change the name to red tape rollback now?

411. 1:18:54

     You can name it whatever you want.

412. 1:18:59

     Do you know the last time- That this was gone through like this and just looked at? I know you're, you're, you're getting rid of a lot of it, but when was the last time that it was really? I mean, to be honest, the, we discovered a lot of these, some of it organically, but we were doing a c- a compliance check- Okay ... for all of our reports that we have to submit to the legislature and all of the boards that we're supposed to oversee, and that was how the vast majority of this bill came to be, is, um, we discovered a lot of this as we were going through.

413. 1:19:32

     So I didn't discover any of this. They brought me- Oh ... the bill. They had done an exhaustive review of, uh, how their operations matched with the state law, and that's how they came up with- Okay ... all of these things. Okay. Thank you. Thank y'all for getting everything up to- Yeah, absolutely ... where it needs to be in today's time.

414. 1:19:59

     Make it ex officio me. Yeah. All right. So come on. Do we have any other questions, comments for the Emergency Care Office Center? Oh, sorry. I got a comment. I got a comment. And Senator Kirkpatrick, thank you for both of these bills, and I hope that we can vote on them both today when we get a quorum. The first bill is, is simply something that our state has a problem with, and we're very siloed in all of our departments and we don't communicate between each department, and I think that is a, a very fair bill that, uh, allows us to provide information cross-department to each other to help keep our physicians honest and keep our patients safe.

415. 1:20:48

     So thank you for bringing that bill. And, and this bill, Megan, thank you for taking the time to, to go through this and, and get rid of language that is, uh, outdated and no longer needed. Uh, I think we need to do more of that, and, uh, I, I love cleanup bills. Red tape rollback, is that what, what you said? Um, 'cause I know, I know that our l- when you read our laws, we have a lot of outdated laws.

416. 1:21:18

     Mm-hmm. And, uh, we need to do a better job of that, so I appreciate the department taking the time to go through that and, and make those corrections. Thank you.

417. 1:21:31

     Representative Thank you, Chair. Um, I just to echo what, uh, my friend over here said about the, the first bill is that once upon a time, we could work in, in siloed things, uh, siloed agencies, and one agency could handle things. And way back in the day, we used to pick up the phone and call one another. Uh, now we send emails, and sometimes it gets bogged down. So I, I understand the need to, for, for continue, especially for, for identifying physicians that are not doing exactly like they need to do and for patient safety.

418. 1:22:09

     We, we need to make sure that everybody's in that conversation that needs to be in the conversation, and those that don't need to stay out of it. Um, so I, I certainly appreciate that, too. Uh, and I'm, I'm with him, too. I like cleanup bills. Um-

419. 1:22:22

     There's a lot of stuff that's sitting out there we need to fix and, and one of them I think might need to go, uh, might need to be addressed or... A- a- am I set okay if I just talk? Okay. As, um-

420. 1:22:36

     Just chatting

421. 1:22:37

     ... the, uh, the issue with death certificates.

422. 1:22:43

     Mm-hmm.

423. 1:22:46

     Where I live in Coffee County, there was, um, a funeral home that had bodies that were there for a while, and families thought that their loved ones were either buried or, um-

424. 1:23:04

     Cremated?

425. 1:23:05

     Cremated. There you go. Only to find out through, um, a raid that there, essentially an investigation that their, their, their loved one had been there six months, eight months, still in there. So I started asking, when I was on one of these committees, I started asking, "What is the trail, the, the, the chain of command for a body from once they're, you know, there's a, a time of death or whatever, from them to final resting?" And there's not really a, a good trail of that either.

426. 1:23:38

     So while you're cleaning this up, some stuff up, I think that would help alleviate some of the problems with that, too. Is it lo- we got a quorum now?

427. 1:23:47

     We, sh- you talked us into one.

428. 1:23:49

     Great. Great. Great. Thank you.

429. 1:23:52

     Thank you for that.

430. 1:23:53

     Thank you.

431. 1:23:53

     We do have a quorum now. We have a motion and a second. Can I get all in favor, uh, say aye?

432. 1:24:01

     Aye.

433. 1:24:02

     All opposed? Okay. Bill passes.

434. 1:24:11

     Hey, okay. I didn't see Cheokas down there, so...

435. 1:24:15

     So they wanted it off the table? We're gonna own the table.

436. 1:24:21

     Okay.

437. 1:24:24

     Okay. We will come back to

438. 1:24:30

     SB, uh,

439. 1:24:33

     395.

440. 1:24:36

     Are we doing that today or another day?

441. 1:24:39

     Um...

442. 1:24:47

     Dave?

443. 1:24:49

     Let's talk about it.

444. 1:24:53

     Please, please.

445. 1:24:58

     Is somebody gonna move to get it pulled off the table?

446. 1:25:04

     Lord have mercy.

447. 1:25:30

     Senator, with the questions that we had on the f- the previous bill and losing the people that were here, uh, that, that, that had a lot of the questions, can we, uh, maybe have a conversation offline and see if we can work something out to move this forward?

448. 1:25:49

     At your disposal, Mr. Chair.

449. 1:25:51

     Thank you, ma'am.

450. 1:25:55

     We are adjourned.