Senate Health and Human Services Committee, February 4, 2026 Video: https://vimeo.com/1161939642 (a timestamp t plays at https://vimeo.com/1161939642#t=s) Page: https://georgiacommons.org/meetings/2026-02-04/senate-health-and-human-services This is a machine transcript of the General Assembly's video, made by a speech-recognition model. It is not an official record and can mishear words, names, and numbers. Speakers are not identified. The video is the record: every timestamp links to the moment it plays. [0:18:26] We ready? [0:18:30] We're rolling. [0:18:32] Make sure it's not burning toast that you're smelling. It's a popcorn. We're still doing this. [0:18:41] Let's call the, uh, State Senate Health and Human Services, uh, Committee to order and open up in prayer, uh, uh, Chairman Huffstetler. [0:18:50] Thank you, Mr. Chairman. We'll pray. Our dear Heavenly Father, we do thank you for all that you have given us, all that you've blessed us with. You've been good to us, and, uh, we hope that we will use the abilities you've given us and the talents to further your kingdom and to serve you. Give us your wisdom in all that we do. We could do it, um, all for your glory. We ask this in your name. Amen. [0:19:12] Amen. Thank you, Chairman. Um, appreciate, appreciate that. Um, we have s- uh, several guests in the audience, uh, Tyra Smith and Woody Williams in the front row there. Uh, they are here to advocate for Mary Dillard, uh, who is a disabled, uh, person in, uh, Woody's class, right? Yes, and my son Walker's, uh, class. [0:19:43] So, uh, we really appreciate y'all here. They're from Savannah, and they were here today, and much appreciated. Thanks for, thanks for being here. Uh, we have two bills in front of us, one a resolution and one, uh, Resolution SR 684 by Senator Halpern and, uh, SB 427, uh, by myself. And, uh, so we're gonna do Senator Halpern's. That came, usually resolutions go, uh, to the floor, but this one was for the State of Georgia, really more of a scrivener's error. [0:20:15] And if you look, uh, on page, uh, two of SR 684, let's, l- let's talk the LC numbers, 44-3361S. Uh, so the difference is on line 28 in it formerly said to the State of Georgia, and that's why it came here, and we changed that to at the State Capitol. Uh, Senator Halpern, would you, uh, would you like to just, um, make any comments here? Uh, the floor is yours if you would like for. [0:20:46] Thank you, Mr. Chairman. Um, I think you laid out very well why this resolution is in this committee. Um, it is American Heart Month in February every year. Tomorrow actually is wear red day at the Capitol. So we realized that scrivener's error, knew that it was sent here, but we're hoping to have this resolution uh, in place for tomorrow's Go Red Day, where the American Heart Association will be here, and we will be able to talk about, um, CPR and AEDs and all of the things that, um, we have often worked on in terms of pieces of legislation in this committee. [0:21:24] So I would be grateful for our favorable passage- [0:21:29] Pass [0:21:29] ... of the resolution. [0:21:30] Well, thank you. Would you like to make a motion? [0:21:32] Yes. I would like to make a measu- re- re- mo- uh, yes, do pass LC 443361S. [0:21:41] All righty. That's SR 684 by substitute, uh, second Senator Robertson. Uh, all those in favor, uh, just say aye. [0:21:54] Aye. [0:21:54] All those opposed like sign. Passes unanimously. [0:21:57] Thank you. [0:21:58] Thank you so much. Uh, so the next one is SR 684, and we have a substitute on that too. I'll explain that when I talk about the bill, but I'm gonna turn it over to, uh, my vice-chair, uh, senator, uh, Chair Lady Kay Kirkpatrick, and, uh, I'll let her run the meeting, and I will present it, uh, from here. [0:22:24] Okay. Mr. Chair, the floor is yours. [0:22:27] All right. Thank you. Uh, so I'll... L- let me take you through the bill, not quite line for line, but almost line for line. Uh, and then I'll show you what the substitute is. It's just the addition of about five or six words here. And then we have, uh, some folks who may have signed up for testimony. If we can get those, uh, that would be great. Um, so you may recall that last year we had a bill relating to, uh, international medical graduates, uh, internationally trained medical graduates, uh, physicians. [0:23:00] And, uh, what we did in all session, uh, we worked with, um, uh, several different, uh, uh, groups relating to this, including the Composite, uh, Board of Medical Examiners and, uh, Composite Board of Medical Examiners. I think I got that right. I renamed y'all earlier, uh, today. And, uh, so, but i- if you'll see, the section one is just definitions, foreign jurisdiction, internationally trained physicians, limited provisional license, uh, and that will come into play, uh, in, a little bit later on. [0:23:36] Medical director, the one who will supervise, uh, that pathway to licensure. What the definition of a rural county, and that's sort of the standard definition that we use, and DCH uses and, uh, CMS uses. It's a county less than 50,000. There are several different definitions, and this is one that is being used. Uh, and then supervising physician, that's the one who is directly, um, uh, supervising, uh, that, and the medical director oversees, uh, uh, all of the, uh, supervising physicians and the international, um, internationally trained, uh, physicians. [0:24:13] So those are the definitions. Uh, those go, are finished on page two. Uh, and then- What the substitute does on line 46, so these internationally trained physicians have been offered full-time employment, uh, under a supers- supervising physician, either at a medical practice located in a rural county or a hospital licensed pursuant to Chapter 7 of Title 31. That's all hospitals in the state of Georgia. And then the substitute includes, "Or accredited medical schools." That's, uh, that's because, uh, medical schools also will employ, uh, internationally trained, uh, physicians too. [0:24:52] So that's why it's a substitute. So, uh, it goes on to state, "Has current active license, good standing, practiced in the foreign jurisdiction, uh, not expired for more than three years. Uh, not, has not been revoked or suspended, restricted or denied." Uh, down on line 30, 56, uh, "Completed 130 hours," so, uh, two and a half years medical school, "in a World Directory medical school, uh, or successor organization." So it has to be recognized in an appropriate fashion. Uh, and, uh, that has, uh, uh, that is a trusted source. [0:25:29] Um, and they have done five years after completing a t- at at least two years of postgraduate training, uh, or has, uh, uh, or there on line 63, or at least 10 years after graduating medical school in a foreign jurisdiction. Uh, and they've demonstrated competency, uh, relating to passing part of an, uh, examination approved by the board. And that's, uh, usually the USMLE Step 1, 2, and 3. Uh, or, uh, many, uh, countries do not use that. [0:26:03] They use the IAMR, the International Association Medical Regulatory Authority. Uh, so that's another way of doing that, um, if you don't take the USMLE. So, um, and then it goes on to talks about, uh, receiving specialty board certification, uh, or, and all these are or, uh, submitting to a comprehensive assessment demonstrating clinical competence, uh, by a program prescribed by board rules. So those are, uh, they, uh, a- as you would suspect, has to show competency in English proficiency, uh, reading, speaking, writing, listening, uh, and is legally authorized to work in the United States. [0:26:46] Uh, has to submit application, pay the fees just like everybody else does, uh, and an interview at the discretion of the board, uh, certainly for any questions or things like that. So, uh, after you've done all that, the holder is limited, has a limited provisional license and shall not practice medicine outside of these parameters, i.e., rural counties, uh, or the hospital. Uh, and a person who violates a subsection, uh, has a penalty of $500, uh, and a ... [0:27:17] Goes on to say l- a provisional license shall be subject to the provisions of this article. Um, and it further defines that, uh, if it, if you stop being, if you stop working, your license becomes inactive, uh, and, uh, or you cease to be employed, uh, and so forth. Um, the gist of this whole, um, bill is really on lines 127, uh, through 139. [0:27:49] So this, the limited provisional license, uh, shall be eligible to apply for a full license to practice medicine after four years of practice at a medical practice located in a rural county or licensed hospital in the state, uh, and, uh, may grant full license to practice medicine, uh, in the state. So, and you've had no issues for two years preceding or the last two years there. Um, and then after that, uh, the license issuance, the board shall require the licensee to provide two additional years of medical practice in an underserved area defined by the board rules, which basically is a rural area of federally held qualified center, uh, meaning, um, uh, rural or urban area that's a needed, a need in our, uh, in our state. [0:28:39] And, um, so, and then the last section, uh, allows the composite board to quantify how many we have. So basically, we really don't have a good tracking mechanism in the state of Georgia to do that, and this allows quantification of that, uh, which I think is a good thing. So we'll actually know, is this, you know, two people or is this, you know, 2,000 people? Um, so I think basically this gives us more pathways, it clarifies it, there's less red tape, uh, and gives us, uh, more options, and, uh, it's just less onerous. [0:29:15] So that's what our plan was, and, uh, hopefully that's what we have achieved. And, um, that's it, Madam Chair. [0:29:23] Okay. Thank you very much. Questions from the committee? [0:29:29] Uh, thank you. [0:29:30] Senator Orrock. I don't have the, um, yeah, you're gonna have to do the mic. [0:29:33] Uh, thank you, Madam Chair. Uh, uh, Chairman Watson, thanks for bringing this. It's, I think, something that's, that's- [0:29:40] Can you speak closer into your mic? [0:29:42] That's, I believe it's- [0:29:42] I'm mumbling a little. [0:29:43] ... something that's been, been, um, uh, th- it's, it's timely and there have been many waiting for some sort of resolution to move forward. Uh, I, I, I may not have listened closely enough, but when you talked about after the four years, where's, uh, where is it? What lines are we dealing with? The two more additional ... Oh, I see it right here, line 135. Um- [0:30:07] Well, it's, uh, it is, the, that two years is having to do if you've had nothing- [0:30:11] Uh, that's right [0:30:12] ... going on with your license. [0:30:13] Yep. Mm-hmm. [0:30:13] And, but the line 138 is two more years in an underserved area. [0:30:18] The board shall require a licensee to provide two additional years In an underserved area, which you, you threw in the federally qualified health centers. [0:30:27] Mm-hmm. [0:30:27] Uh, uh, uh, w- would that, that, that already was a place that they could, uh, be gainfully employed. [0:30:34] That's in the rules. That's in their rules. [0:30:35] Uh-huh, uh-huh. Thank you. [0:30:39] Other questions? Senator Robertson or Tim. [0:30:43] Chairman Watson, um, on line 83 and 137, could you give me a definition of moral turpitude? [0:30:52] Uh, we will get, uh, former Chairman Mullis here who can do that for us. [0:30:56] Right, channeling Mullis. [0:30:57] Yeah. [0:30:57] Oh my God. [0:30:58] It's only 4:00. [0:31:01] I thought we'd taken some of that out. [0:31:03] And the answer is you know it when you see it. [0:31:05] That's right. [0:31:07] Other questions? [0:31:08] Yeah, I have a question. [0:31:09] Okay. Senator Halpern. [0:31:12] All right. [0:31:14] I very much like this bill. [0:31:15] I guess I'm getting bored. [0:31:16] Very much in support of it. I have one question, and that is just how do we make sure that there are not people who will game the system, Americans who will game the system by going overseas and then coming back? [0:31:34] Well, you do have the board to investigate that, and they do have investigators, but, uh, there are people who go over to, uh, England, uh, and to Canada to, I mean, really great medical schools and residency programs. And those are really fully accepted from that standpoint. So gaming the system would be through, uh... When they apply, they've got to have all of these aspects of that. And those, like people go to the, don't get into medical schools in the US and go to the Caribbean. [0:32:04] Yeah. [0:32:04] And then they come back, generally will finish their last two y- clinical years, and then they will ha- have to pass the same thing, step one, two, and three, and then do a residency and all of those that are accepted. The, um... And I mean, the fact is we get the cream of the crop from, from places like that. [0:32:22] Yeah. Yeah. Thank you. [0:32:23] Because the residency programs, you know, sort of demand that. [0:32:26] Yes, sir. Yeah. Thank you. [0:32:27] Senator Setzler had a question, and then Sen- Merritt. Merritt. Merritt. You go. Okay. [0:32:33] Okay. [0:32:33] All right. [0:32:34] Senator Merritt. [0:32:34] We're ignoring you. She's, she's the chairman. I'm just, I wa- [0:32:36] I know. You need to stop directing traffic [0:32:36] ... and I was, and I was pointing. I'm sorry. [0:32:39] No worries. [0:32:39] Uh- [0:32:39] Senator Merritt, go ahead. [0:32:41] Uh, thank you, Mr. Chairman. So I have, um... My concern is, um, and I appreciate this bill. I know what we're trying to do. We're trying to get more, um, medical professionals and more doctors here because we do have a shortage. I guess my question is, um, I see where we're kind of vetting where they're coming from, the World Directory of Medical Schools. Now, when they get here, because we are having questions about immigration, what kind of status are they coming here under? Is this a work visa? Is this a, would they have protected status when they're here? [0:33:12] Because I would really hate for a physician to be here and then get wrapped up in something like, you know, ICE has detained them or, or something of that nature. So is there some protections for these doctors that are coming over here? [0:33:24] This, lines 88 through 93. [0:33:41] License, health... [0:33:45] Okay. [0:33:48] I think it says, I think the key word there is, uh, 88 is, is legally authorized and not illegally authorized. [0:33:54] Mm-hmm. Right. [0:33:55] I mean, I, I will tell you that I have a, I'm, I'm pretty- [0:33:59] But- [0:33:59] I, I practice in a community with a lot of foreign, uh, foreign or internationally trained physicians. [0:34:05] Right. [0:34:06] And they jump through all the he- hoops to get here legally, and- [0:34:10] Correct [0:34:10] ... uh, it is, that's why it's so totally unfair in my opinion. [0:34:15] So that's just my clarification- [0:34:16] Sure [0:34:16] ... Mr. Chairman. Those that we, they're already here, is that what we're saying? [0:34:21] No, they're legally here. They're, y- you know, the, the composite board may be able- [0:34:26] Okay [0:34:26] ... will be able to answer that better than I. [0:34:27] 'Cause the question is we have people that are legally here now, yet they are still getting detained. So I'm just trying to clarify what protections those folks have. [0:34:35] Senator Robertson, you want to address that or? [0:34:38] Yeah, I can... Anybody that's legally here that is a, is a dual citizen of another country or if they're here on a temporary work visa or whatever, the only people that are being detained, if they have outstanding, uh, legal issues here in the United States or if they have outstanding legal issues or crimes committed in other countries or warrants have been taken out there. Um, as far as these operations are moving, these operations move with individual names attached to the operations. And so from a law enforcement standpoint, um, these are targeted individuals who have legal issues within the United States, not normal everyday working, uh, nationals who come here the proper way, have all the certifications, and are going about doing their jobs, whether these are in hospitals, clinics, convenience stores, hotels, or anywhere else. [0:35:25] So I think the terminology you put in here, in my mindset, um, it, it answers the question exactly, uh, Mr. Chair. [0:35:32] Okay. And I wasn't trying to be contentious in any way, but I do know we are having an issue, and I'm just trying to make sure that we're closing any loopholes or anything that might be unintended out there towards workers that we, they're here legally, but just making sure they are here legally and they are able to do the work that they, you know, came here to do and be doctors. The other question I had really quick was I know this just is for rural areas right now. Is there any reason why we're just doing this in rural areas? Because we do have some, we do have places here in the city that also are experiencing a doctor shortage and... [0:36:08] Well, that was the, the spirit of this was through medical schools, hospitals, uh, or rural areas, and that was felt to be the full need. If, and after, that's four years of observed, uh, training or observation, not necessarily training, but observation, and then they would follow up with two years of service in underserved areas- [0:36:32] Okay [0:36:32] ... like you're talking about. [0:36:34] Thank you. [0:36:35] Uh-huh. [0:36:35] Uh, Senator Setzler. [0:36:37] Thank you, Madam Chair. I appreciate the, the, this. A number of years ago, helped a foreign doctor navigate the system we have now, which is not an ideal system. But I, I have some personal interest in this, and I appreciate the, the spirit of it, I really do. I, I, um... I guess is someone gonna come and speak against this today? I wanna hear a full-throated argument why this is a bad idea- [0:36:58] Uh- [0:36:58] ... just so I can kinda frame where my thinking is on this. [0:37:01] Yeah. [0:37:02] Is there gonna be any discussion that's, that's against this bill? [0:37:05] Uh, there's nobody on the list to testify against the bill. [0:37:08] 'Cause I just... You know, I, I... My question would be, why are we not doing it everywhere, as, as, as the lady questioned. I, I mean, I, I, I like the idea. Is this a, is this a, is this a way to get people to prac- in areas that maybe not are as easy to practice in or to get people to go to? I'm not against this. I just... [0:37:28] W- it's just there, there's, there's two sides or three sides to most stories. I just want one here the... Somebody that had an opinion that thinks this is a bad idea. That's all. [0:37:36] Um, Senator Harrell, did you have a question? [0:37:39] Sorry. [0:37:41] Get to you in a minute, Mr. Chair. [0:37:43] Uh, so my... Uh, my question, uh, refers to, um, the section that begins, I believe, on line, uh, let's see, 65, um, where it gives various options for demonstrated competency. Um, I imagine there are options there to cover, uh, a number of different, um, situations. Uh, but I'm, specifically have questions about two, uh, situations that might not be covered under these, these options. [0:38:17] One is, um, the requirement to... Uh, well, it's not a requirement, it's an option to do a, a clinical, uh, demonstrate clinical competency. Could somebody who's needing to use that option, um, not be able to utilize that option because they don't have a license yet? [0:38:36] You know, I- [0:38:36] So they wouldn't be able to- [0:38:37] Yeah. And I, I apologize. So the... Part of the issue here is that someone is, is, comes in with less training than anybody here in the US, and that's just not an option. So if you demonstrate that, it's like those successfully doing the USMLE, the step one, two, and three- [0:39:03] Mm-hmm [0:39:03] ... or doing what's recognized at International Association Medical Regulatory Authorities. So you gotta do that. Everybody else in the United States has done that. [0:39:12] Okay. [0:39:13] Chair- [0:39:13] Uh, what about people who, this is in the same category, what about people who, um, [0:39:21] w- the number, the, the provision, um, American Board of Medical Specialty C? What if they're not members of that, and then they can't utilize that option? [0:39:32] Let's see. [0:39:33] Like Ukraine or Af- Afghanistan. [0:39:35] Where are you? [0:39:36] Um- [0:39:36] So line 76. [0:39:38] Yeah, 76. Line 76. Uh, I understand there are some countries that are not members of that, like maybe Ukraine and Afghanistan, and they wouldn't perhaps be able to use that option. [0:39:51] Yeah, I mean, that's... Listen, if they're board-certified in American Board of Medical Specialties, Bureau of Osteopathic Specialists, American Osteopath, Board of Rural College Physicians and Surgeons, Canada, then this is, as I stressed in my presentation, line 79, it is an or. [0:40:07] It is an or. That's true. [0:40:09] Mm-hmm. [0:40:09] Just wanted to make sure that everybody's covered under all the ors. [0:40:13] Yeah. [0:40:14] And that we're not, you know- [0:40:15] So if you're board-certified- [0:40:16] ... leaving anyone out [0:40:16] ... then yes. [0:40:17] Okay. Chairman Brass. [0:40:20] Yeah, I kind of, since we don't have anybody speaking against it, I'll tell you, uh, I wanted to kinda help Senator Setzler on the, some of the opposite that, that has come to me. And this, I just wanted to share it. It doesn't necessarily mean I'm against it. But, um, I was with a doctor last night at dinner and, and this bill was brought up. Uh, I believe there's a House bill as well, and there's a Senate bill. Is that correct? Doesn't- [0:40:48] I think so. [0:40:48] Not aware of a House bill. No. [0:40:50] Oh. [0:40:50] There's not a House bill. [0:40:51] I thought Chairwoman Cooper discussed it last night. But either, either way, it doesn't matter. [0:40:55] Not a House bill. [0:40:56] Doesn't matter. It, it... The subject came up last night, and so the doctor sitting next to me, who I've known for a couple years now, I asked him the question. I said, "What's your thoughts on that?" And, and you've already stated it, Mr. Chairman, as long as, you know, you're meeting, as long as they can still meet these requirements and there's not a lack of, of knowledge or training or experience, um, then he was good with it. And so I just wanted to say that for that. Another concern that, of, came to me, I got a call from one of our Senate colleagues on Saturday, and, um, he got a call from one of his local APRNs, and he was con- That APRN was concerned that, you know, why are we gonna let, um, foreign doctors come in if, if we're not gonna allow the APRNs to come in? [0:41:54] But I think, again, it goes back to those, as long as you're meeting those requirements, then, um, and meeting the standards that we set in the state, then it's okay. So anyway, I just wanted to share that for Senator Setzler to... I know he likes to have lots of things to chew on in, in his brain. So there's your two things to chew on. [0:42:17] Uh, Senator Orrock, we do have people signed up to testify, so... [0:42:21] That's right. Well, I, I'm just, I'm just trying to be sure. Uh, the, the federal, federally qualified health centers w- was, uh, w- mentioned in, uh, referenced when you presented the bill, but what, where does that... There, there are fe- there are federally qualified health centers that are not in a rural county, uh, that are not a licensed hospital, and they're not an accredited medical school. So how do they, how do they- How do we match up that we, we clearly want them to be able to practice in those settings, do we not? [0:42:53] Yeah. Let's, uh, let's let the board, uh... Do you mind, uh, stepping to the podium or down here? [0:42:58] Thank you. [0:42:58] Just identify yourself, um, and, um, tell us, help us out here, please. [0:43:05] I'm Kimberly. I'm the deputy executive director with the Georgia Composite Medical Board. Um, so the board has vetted this bill a lot. Um, and their reasoning for not wanting to include federally qualified, uh, healthcare systems is because a lot of them are not actually manned by a physician, and this bill would require a physician to be on site with the internationally trained physician at all times. And a lot of those facilities are actually run by APRNs or PAs who would not be able to supervise this physician. [0:43:40] So- [0:43:41] But they would be able to practice there after those, uh, four years. [0:43:44] Right. For the two years of underserved, they would be able to do- [0:43:47] That's what they're referencing [0:43:48] ... FQHC. [0:43:48] That's right. [0:43:50] Those, those last, the additional two years. [0:43:51] Yes. [0:43:51] Right. And that, and you know, listen, if you're practicing there, um, with a full license, then you're more likely to stay there, so. [0:44:00] Well, I'm- [0:44:00] But, uh, you know. [0:44:02] So does that, so, so yeah, that, that answers my question. [0:44:07] Okay. [0:44:08] Thank you. [0:44:09] Uh, Senator Setzler, you have one more? [0:44:11] Yeah, uh, uh, Madam Chair, probably have some more than that after we hear some testimony. My question is, is this a circumstance where, um, for example, would this qual- would these roles qualify for an H-1B visa where there's a high need profession, or is this gonna be somebody that's here, um, s- 'cause it, get- my, my concern is if this is gonna be a circumstance... And I'm just get, get... We just have to say things. I'm just gonna say it. Uh, if this, if this is gonna be a circumstance where there's gonna be an effort to recruit foreign people to come here, um, to work for lower pay than doctors here, um, there's gonna be, the- there's some, some kind of, some kind of drive to s- s- some business model driven thing, we want, we wanna maintain a, a, a level of care, and I just don't know what, um... [0:44:56] I'm not against it. I just wanna under- We need to talk about things in this, in this setting. Are there any other states that have taken steps in this way that have seen a rush towards s- sort of a bias against, um, doctors trained in the state and their own m- [0:45:13] Medical boards, Chairman, please [0:45:14] ... th- through, through, through their own universities, their own, their, their own, um, um, residency programs. Um, again, I, I, I'm very, very sensitive and I think we're, uh, I think we'd do great to allow foreign doctors who wanna be in this country, wanna give them opportunities. We just have to ask the hard questions, and I don't... This is n- this is not a subject matter I know a lot about, and that's wh- I think we need to put those on the table and ask what's happened in other states. [0:45:36] So there are a lot of states that are trying to pass these kinds of bills right now. Um, a lot of our, some of our people actually went to the IAMR conference in Ireland this past year, and a lot of the feedback that, that they got from the other countries was that no state has actually passed something that has worked- [0:45:54] Oh [0:45:54] ... that's allowed their act- their citizens to come to the United States to practice as physicians. Um, so this bill was actually modeled a lot after, um, something that North Carolina just enacted. Um, theirs went into effect on January 1, so we don't know what the actual impact in North Carolina is just yet. Um, but we do know that they stated that the things that other states have done in the past, I believe Tennessee had one, they have a couple out west, they said that none of those have actually worked to date. [0:46:24] And, and the, th- th- the not working means it didn't really create a meaningful pathway for, for qualified- [0:46:31] Correct [0:46:31] ... foreign-born physicians who live here that wanna practice to be able to practice? [0:46:35] Correct. [0:46:35] Or what was the, what, what was kinda the nature of the problems they saw? [0:46:39] They didn't, I don't think they went into description about that. Jason was actually there. [0:46:43] Mm-hmm. [0:46:43] This is our executive director. [0:46:45] Hey, I'm Jason, uh- [0:46:46] Hey [0:46:46] ... executive director for the medical board. So, uh, they didn't really go into that. But what the, um, the reason why, none of the other states had a medical director that oversaw this, so they didn't have a way to develop a program that's gonna work, uh, and, and make sure that hospitals, uh, will have a, a kind of a map to do this. So that's the reason we're wanting to have a medical director involved in this so that they can help, uh, with those processes and make sure that they're not gonna have those factories that are gonna pay, pay these doctors less. [0:47:18] Um, so there's gonna be some oversight with it as well. And no other state really had oversight, uh, with this, this type of bill. [0:47:25] So, so are... What we think is best about this is we, we're, it seems like we're creating sort of a four-year residency equivalent kinda program where they're operating under a sort of another attending physician. Even though they're, they're trained as a physician themselves to verify, as they kinda- [0:47:40] Correct [0:47:40] ... walk together, they can- [0:47:41] Mm-hmm [0:47:42] ... they can, they can be independent. [0:47:43] Doing residency [0:47:43] Yeah. [0:47:43] Correct, because these physicians- [0:47:44] This, this is so cloudy [0:47:45] ... are coming over from other countries. They're not familiar with the US healthcare system, um, and common US healthcare practices. So this helps them kind of assimilate into the US healthcare system. [0:47:56] What's the, what is the... For somebody who's trained in another country's system, uh, I don't know what the standards of care are for certain practices in o- other countries versus the United States. I wouldn't preserve, I wouldn't r- presume ours are better or, or worse. I just wanna ask the question. Is there a, is there a professional practice in this where folks understand, hey, you know, in this setting, i- is that kinda what the four years does? They kinda learn the standard of, the standard of care in their subspecialty before they're kind of on their own? [0:48:26] Is that the thinking? [0:48:27] Yes, sir. [0:48:29] Okay. [0:48:29] And, and the, uh, IAMR, um, the reason why we wanted the IAMR, uh, in here was most of the countries that are with IAMR have those same standards. So they're gonna have the standards of the US and have the good training, uh, and processes before they come here. So we already know this. [0:48:47] Thank you. [0:48:48] Senator Brass. [0:48:50] So- [0:48:53] Thank you, Madam Chair. Is there any concern- [0:48:56] Yeah, one [0:48:56] ... where a US citizen would maybe be want to go to a foreign country and get, go through med school and then come back if it, if it were cheaper? And are we kinda open... I mean, is there a concern we're, we're- [0:49:14] I believe- [0:49:14] ... kinda opening up that- [0:49:15] I believe that question- [0:49:16] ... box [0:49:16] ... was asked before you got here. [0:49:18] Was it? I'm sorry. [0:49:18] Um, no, no, no, that's fine. Um, but the question, the previous question was is there a way to game the system of- [0:49:24] Yeah [0:49:24] ... such as- [0:49:25] And that's kind of- [0:49:25] ... leaving the country- [0:49:26] Right [0:49:26] ... going out of state. Um, so if somebody chooses to go to a medical school in another country, I believe, uh, Senator Watson was talking about, you know, other healthcare systems such as, you know, uh, the UK, they all have, they have excellent healthcare systems. [0:49:41] Mm-hmm. [0:49:41] So those are excellent schools. Um, but it would be possible, but they would still have to meet all of the same requirements as every other ITP. So they would still have to be part of an, an IOM or a country- [0:49:54] Mm-hmm [0:49:55] ... take a nationally recognized board exam, have at least five years of practice if they have done a two-year residency in that country. If they haven't, then they would've had to practice in that country for 10 years. So this, this bill is not geared towards your new medical graduates. [0:50:10] Mm-hmm. [0:50:10] It's geared towards your veteran practitioners that are looking to come to the US. [0:50:15] That's a good point. [0:50:15] And you've still got the oversight for two years as- [0:50:18] You actually have it for almost six- [0:50:21] Four. Yeah [0:50:21] ... because you have the four year- [0:50:22] Oh, so they have to work under another doctor for- [0:50:24] Yeah [0:50:24] ... six years. [0:50:25] Four. [0:50:25] For four years. [0:50:25] Four years. [0:50:26] And then they have to do an additional two years in an underserved community. [0:50:29] Oh. [0:50:31] Okay. Um, could we get on with the testimony, please? Committee ready? Um, Stephanie Zenker. [0:50:42] Please introduce yourself. [0:50:44] Sure thing. Good afternoon, Mr. Chairman. My name is Stephanie Zenker, and I am the strategic director for the LIBRE Initiative in Georgia. And for those of you who aren't familiar with us yet, we focus on empowering the Latino community so that they can prosper and achieve their American dream. I'm here to speak in support of Senate Bill 427, and I wanna stress the importance of this bill specifically for the Latino community, which comprises 11% of Georgia's total population and continues to grow very rapidly here. So around the entire US, we are confronting a critical physician shortage, which impacts over 83 million Americans in underserved areas, and this issue obviously resonates personally with our communities here in Georgia as well, um, where we have dozens of counties with limited, uh, physician access. [0:51:32] So on top of being in very underserved and rural areas and frequent and burdensome travel barriers to being seen by a physician, Hispanic adults are also less likely, uh, than other Americans to have been seen by a healthcare provider recently and to even have a primary care physician in the first place. Um, so we know that the best prevention for poor health outcomes is preventative medicine, and minorities and rural Americans simply face more barriers to get that. [0:52:02] On top of that, already many immigrant physicians are already here. They're trained, they're experienced, and they're ready to work. Um, these doctors bring critical language skills and cultural understanding to underserved Latino communities and other minority communities, which improves trust, communication, and health outcomes. And so a healthier community is one that is stronger and more productive and can contribute to Georgia's thriving economy. So these steps are vital for alleviating the healthcare provider shortfall, ensuring accessible medical care for all Georgians. [0:52:35] So we urge your support in advancing these measures for the health and wellbeing of our robust and growing Latino communities here in the Peach State. I thank you for the opportunity to speak, and I urge the committee's favorable consideration. [0:52:48] Thank you very much. Next, uh, Clint Dixon. [0:52:57] Hey, good afternoon. Uh, Clint Dixon with Georgia Public Policy Foundation and Georgia Policy Impact testifying in support of this bill. Uh, would like to thank Chairman Watson for his effort to bring this concept forward. Uh, it's been several years' worth of journey at this point. Um, I just wanted to point out that 18 states have passed a version of this legislation. Uh, that includes Tennessee, Florida, and North Carolina. Um, and so there is not only this issue of trying to get providers in underserved areas, but we also have a situation where, um, if a foreign-trained physician wants to come over now, they're competing for a limited number of residency slots with our domestic medical school graduates. [0:53:36] So this legislation also creates an additional pathway to kinda, you know, break up that logjam, if you will. And, um, this concept is, um, spreading so quickly that the American Board of Internal Medicine is now creating a pathway to being a board-certified internal medicine doc, um, under a international, um, licensed physician pathway such as, uh, this bill would provide. So I just wanted to share that and thank you for this bill. [0:54:03] Thank you so much. Mr. Chair, do you want to close? [0:54:06] Thank you. [0:54:07] Oh, sorry, Senator Hufstetler, you had a question? [0:54:10] Yeah. Well, just before it closes, I was trying to... You know, we, we talked about the rural area and why are we looking at that and that sort of thing, and the fact is we have a huge shortage in the rural area, and we do tax credits to try to incentivize doctors to go there. We say, "We'll pay your tuition for a couple of years or, or whatever to get you there," and, and some of them go and then leave because they know they can do better in a city, city setting or, or they just don't do it. [0:54:41] Um, so this is, this is very restrictive with this six years in, in here. I'm not saying to make it less restrictive, but it is pretty restrictive, so I think if it doesn't work, it'll just be because it, it is It, it's a pretty tight restrictive program to take six years under it. Um, I'm, I'm fully supportive of this bill, but I do think that, uh, if it helps in any way address the shortage in rural areas, then it'll be a great thing. [0:55:08] Yeah. I, I think it... I agree. Thank you for your comments. I mean, I think it is a piece of the puzzle. Um, maybe I'm out of, I'm out, out of turn here. Uh- [0:55:16] You came close. [0:55:17] Okay. I... It i- it is a piece of the puzzle. Um, and there are, you know, institutions, uh, like TIF Regional has really embraced the aspect of, uh, recruiting physicians, but it, it, those credits not only are ph- physicians but for, uh, PAs, nurse practitioners, and then remember we added it in for mental health professionals too, uh, with the mental health parity bill. So, uh, it's, it, it is not a panacea. This is not a panacea, but I think it is, is a piece. [0:55:49] I mean, this is, in conclusion, I mean, this is something to make it less onerous, less red tape, more options, uh, more pathways. Uh, it's something that I think is long overdue. But you assure quality for our patients, uh, throughout the state, and I think that's, uh, ever so important to let you allow, uh, this pathway. Um, I'll be happy to answer any questions. [0:56:14] Senator Orrock. [0:56:15] Oh, thank you, Madam Chair. Yeah, the question occurs to me, uh, if, if there are- [0:56:20] Mm [0:56:20] ... federally qualified health, uh, facilities t- that are under the, um, uh, uh, supervision of a- [0:56:31] Doctor [0:56:31] ... a doctor as opposed to an advanced practice, uh, nurse, et cetera, that, uh, uh, uh, uh, allowing them to, to, to, uh... Al- al- allowing that to be a po- a, a, a position that could be filled in the bi- uh, for the, uh, medical professionals that are described here might be something to look at in the future. I mean, I'm not suggesting we turn the world around now and ... But, but it, but I, but, but, but, but it's a re- it's a real thing, and I, and, and that, that'll be an, an interesting question. [0:57:02] I, I, I was not aware of what was pointed out, uh, to us today. Thank you very much for the bill. [0:57:11] Okay, if there are no other questions, I'm ready to- [0:57:14] I'd like to make a motion. [0:57:14] Okay, Senator Hufstetler, you wanna make a motion? [0:57:17] Sure. Uh, I'll, I'll move that we, uh, do pass the substitute to Senate Bill 427 LC 52 1007S. [0:57:26] Second. [0:57:27] Second. [0:57:27] Okay. Senator Setzler seconded. Any further discussion? Okay, all in favor, raise your hand. [0:57:33] You don't raise. You're the, you're the chair. [0:57:36] Oh. Yeah, I forgot I'm the chair. [0:57:38] Vote it. It's unanimous. [0:57:40] Okay, any opposed? I think that's unanimous. Thank you very much. [0:57:44] All right. [0:57:45] And I think we're done. [0:57:47] I think we are done. Thank you. Meeting adjourned.