Budget hearings at the start of Georgia’s legislative session saw state departments delve into Gov. Brian Kemp’s proposed budget and make the case for funding priorities.
Appropriations for the state’s four major health departments next fiscal year include more than $7 billion for mental and behavioral health services and an expanded HIV prevention program, among others.
But the main concern this year is the repeal of a pandemic-era policy that kept people on Medicaid without interruption and is set to expire in April. Called continuous coverage, the federal policy has led to a 25 percent growth in Medicaid enrollment since the start of the pandemic, five times what would have been predicted under normal circumstances, said Department of Public Health Commissioner Kaye Nogle.
DCH will work with the Department of Human Services to reassess more than 2 million adults and children in Georgia next year. More than half a million are estimated to lose Medicaid coverage in the process.
The FY 2023 budget includes $8.4 million to fund additional staff and administrative support for grants, with an additional $3 million for FY 24. But DHS says its staff will likely see caseloads increase by more of 200%.
“We have retrained current employees and are aggressively hiring new ones,” DHS Commissioner Candice Bross said during the budget hearings. “Please note that while we redefine Medicaid cases, we will continue to receive new benefit applications, process renewals and process appeals.”
With a launch date set for July 1, $52 million in the budget will cover implementation of Kemp’s Medicaid waiver, Pathways to Coverage. Roughly 200,000 people already on Medicaid could be eligible for that waiver and be automatically transferred during redetermination, according to DCH, but that still leaves thousands more to determine eligibility under the partial expansion program .
“Over the next 12 months, there’s going to be so much movement of members coming in and members going out,” Nogle said.
One of the department’s first moves is to reopen 158 offices across the state to shift from remote work to offering in-person assistance. This includes the re-opening of all offices under the Department of Family and Children’s Services, with plans to hire more staff and open more frequently in the coming months.
Teasing legislation on another important issue, Brousse said DHS is committed to ending so-called foster care placements and “fixing loopholes” in the foster care system.
“You can’t make progress in your foster care cases if you’re looking after a high-needs child in the office or hotel room,” Brose said.
Broce said demand, which means the number of children with complex problems who need accommodation, “far outstrips supply”. The lack of staff or foster families available for high-needs children means that an average of 60 foster children sleep in local offices or hotels every night.
Even if children in the foster care system need psychiatric help, it is often not available to them.
Department of Behavioral Health and Disability Commissioner Kevin Tanner said state mental hospitals have lost 1,200 staff during the COVID-19 pandemic. Although staffing has improved since then, hospitals still spend millions on temporary workers.
“These contract workers are expensive,” Tanner said. “We want to replace them with DBHDD employees who are not only more cost-effective, but also more committed to the department’s mission.”
The budget includes $2,000 in cost-of-living adjustments for full-time state employees. The additional federal funds are intended to address staffing shortages in the health care system.
Currently in the budget, more than $14 million for DBHDD will help keep more people living with intellectual and developmental disabilities out of institutionalization. This money will be both annual and will fund additional slots for the New Options Waiver and Comprehensive Supports Waiver programs, providing home and community care for more than 700 people.
The budget also includes increased funding in FY24 for mobile crisis response units and more than $13 million for three behavioral health crisis centers in Augusta, Dublin and Fulton counties.
The Department of Public Health plans to focus on maternal mortality this year, Commissioner Kathleen Toomey said.
“I think addressing maternal and child health in a very proactive way is probably going to be my top priority,” Toomey said.
But there are no new funds in the budget specifically for maternal mortality.
Leah Chan is a senior health analyst at the Georgia Budget and Policy Institute. She said that while DPH is well positioned to address the maternal mortality crisis, the new appropriations do not reflect that priority.
“The budget is a moral document,” Chan said. “And to me, that speaks volumes for what the governor values. We have the solutions. This is a preventable problem. And it’s really just a matter of urgency and investment. So I really think that’s a missing part of our budget.
Last year, DPH received funding for two pilot projects targeting rural areas and one at Augusta University to monitor mothers before and after birth, and Toomey says those projects are underway. Legislators also approved Medicaid coverage up to one year after birth during last year’s session.
Toomey said a February report will provide more data on maternal mortality and that the public is likely to see more cases because of the pandemic.
This article appears on Now Habersham through a news partnership with GPB News