DHR Re-organization Begins Today

Governor Sonny Perdue has high hopes for the restructuring of health and social service agencies in the state. That begins today with the arrival of the new fiscal year.

Basically, the sweeping changes will spread the services previously handled by two agencies—Department of Human Resources and the Department of Community Health—to three. The main reason is to help Georgia to get a better handle on its failings in mental health, which has been under the federal microscope over the past year.

Governor Perdue says he’s confident of future success for the newly-created Department of Behavioral Health and Developmental Disabilities:

"I firmly believe by separating these functions organizationally, the resulting standalone department focused on mental health will be a nimble, flexible and responsive unit…better able to fully implement the commission’s recommendations."

Advocates are hopeful, yet worried about whether the state’s continued budget crisis will cripple the effort.

Perdue says other areas of concern, like access to vital records, should be better handled in the new set-up.

Georgia gets near-failing grades in new emergency care report

A national report released today gives Georgia’s emergency medical care near-failing grades.

The American College of Emergency Physicians second National Report Card says Georgia’s got some serious medical homework to do: Georgia ranks 31st on the list, says ACEP President Dr. Nick Jouriles:

“The emergency care system is a ticking time bomb made worse by the financial crisis, and a failing nation’s healthcare system.”

Statewide, “failing” stands for an “F” in access to emergency care.

The report also gives the state C’s and D’s for too little disaster planning, and too few medical providers serving too many uninsured residents.

Doctor Matthew Watson is an emergency room physician at Atlanta’s Northside Hospital:

“By not having all of the different subtypes of physicians available, this limits our ability to care for the patients in a timely fashion.”

And in a bustling emergency room, that means,

"If patients come into the emergency department that we can’t provide the care for, then that’s going to slow down the next patient that needs to be seen, which is ‘domino effect,’ it’s just going to slow down the providing of care to all of the patients.

The report says more than 80 percent of the state’s residents live within an hour of a Level I or II trauma center.

Watson says, however, that part of the problem is getting doctors and other medical providers to work with limited equipment in many parts of the state:

“In rural areas, you simply don’t have the facilities that could support open-heart surgery, or any of the other specialties at a smaller rural hospital.”

The report has some bright spots: Georgia ranks first in the nation for patient access to substance abuse treatment services.

As well, liability reform laws also get high marks for limiting frivolous lawsuits and lowering medical liability insurance premiums.

The report, partly funded by The Blue Cross Blue Shield of Georgia Foundation, recommends training more emergency doctors and residents, critical medical specialists, registered nurses, and primary care providers.

Click here for more GPB News coverage of health care issues.

DCH plans extra fees on private health insurers

In order to keep Medicaid and Peachcare going in its current form, the state’s top health agency wants to expand a plan that would charge private health insurers millions of dollars in extra fees.

The Department of Community Health says the call for statewide agency budget cuts makes the action necessary.

DCH is looking to account for over 100-million dollars in needed funds. Without it, the agency says it might have to drop some people from the rolls of Medicaid and Peachcare.

State lawmakers in 2005 passed a measure approving the fees charged of three national companies managing Medicaid and Peachcare.

Dr. Carla Denise Edwards, DCH chief of staff, says this plan expands fees to HMO’s across the state. It's something Edwards says is crucial:

"Without the managed care fee, the state of Georgia is at risk of losing $90 million that would normally be available to ensuring that we had funds for the Peachcare for Kids program, as well as the Medicare program. Without this fee, we don't have the money to run those two programs".

Kirk McGhee is executive director of the Georgia Association of Health Plans, a non-profit industry trade group. He says this would hurt some individuals and small businesses by "pricing them out" of coverage. McGhee says this is something that has to run through the Legislature.

"Certainly I would think that Georgia taxpayers and consumers and voters would want those decisions to be made not by a single bureaucracy in the state, but be made by the people they elected to make such decisions".

CDC: South not scaling back obesity

The South tips the scales again as the nation's fattest region, according to a new government survey.

Overall, about 26 percent of the CDC's telephone survey were obese.

More than 30 percent of adults in each of the 10 states surveyed tipped the scales enough to ensure that the South remains the nation's fattest region.

Georgia ranks eighth out 10 states with the highest levels of adult obesity, according to a 2007 survey by the Centers for Disease Control and Prevention

Colorado was the least obese, with about 19 percent fitting that category in a random telephone survey last year by the Centers for Disease Control and Prevention.

Survey results:
1. Mississippi, 32.0 percent
2. Alabama, 30.3
3. Tennessee, 30.1
4. Louisiana, 29.8
5. West Virginia, 29.5
6. Arkansas, 28.7
7. South Carolina, 28.4
8. Georgia, 28.2
9. Oklahoma, 28.1
10. Texas, 28.1
Source: Associated Press

Dr. William Dietz, who heads CDC's nutrition, physical activity and obesity division says the traditional Southern diet -- high in fat and fried food -- may be part of the answer.

The South also has a large concentration of rural residents and black women -- two groups that tend to have higher obesity rates, he said.

Obesity is based on the body mass index, a calculation using height and weight. A 5-foot, 9-inch adult who weighs 203 pounds would have a BMI of 30, which is considered the threshold for obesity.

CDC officials believe the telephone survey of 350,000 adults offers conservative estimates of obesity rates, because it's based on what respondents said about their height and weight. Men commonly overstate their height and women often lowball their weight, health experts say.

"The heavier you are, the more you underestimate your weight, probably because you don't weigh yourself as often," Dietz said.

Overall, about 26 percent of the respondents were obese, according to the study, published this week in CDC's Morbidity and Mortality Weekly Report.

A different CDC survey -- a gold-standard project in which researchers actually weigh and measure survey respondents -- put the adult obesity rate at 34 percent in 2005 and 2006, the most recent years for which there are data.

Click here for more GPB News coverage of health issues in Georgia, and here for more coverage about the CDC.

(The Associated Press)

Gwinnett hospital's open heart program challenged

Officials with Gwinnett Medical Center hope its timetable to start-up a new open heart program will not be derailed by appeals filed by three Atlanta-area hospitals. The Gwinnett Daily Post reports Piedmont Hospital, Emory University Hospital and Emory Crawford-Long Hospital filed paperwork with the state Department of Community Health last week. The hospitals want the agency to reverse its approval in June of Gwinnett Medical Center’s new open heart program. A planned expansion for the program is scheduled to begin construction in July of next year, with the program start-up slated for late 2010. A decision on the appeals could come by early November.

Health care group launches campaign

A health care advocacy group launched a multi-million dollar campaign in Atlanta today to press for reforming the American health care system.

Health Care for America Now is a coalition of more than 100, primarily left-of-center groups calling for cheaper and more comprehensive health insurance and health care.

Larry Pellegrini of the Georgia Rural Urban Summit, says the coalition plans to invest $40 million dollars to get their point across nationwide:

"…which would actually make it one of the largest, if not the largest campaign on a single issue that's ever been formed. The funding is already obtained, and we intend to make it an investment in reforms that will satisfy the needs of the people."

The group is touting a 10-point plan they want to see on the national agenda, including universal health care, a choice of private or public coverage, and equal access to treatment.

Organizers say their supporters include labor unions, women's and minority groups, medical practitioners, and small-business associations.

Click here for more GPB News coverage of state health-care issues.

Data breach of Medicaid and Peachcare enrollees

Georgia's Department of Community Health is investigating how private information of roughly 70,000 Medicaid and PeachCare enrollees ended up on a publicly-accessible website. The data included names, birth dates, social security numbers and some medical information of members who get their care through WellCare Health Plans.

Director of Compliance for Georgia's Department of CommunityHealth, Ruth Carr said it was due to human error. "Our foremost concern was making sure all of the affected members were notified as soon as possible," said Carr.

According to a WellCare spokesperson, the information became unsecured on February 12th, when a routine update accidentally removed the security component for the electronic data.

WellCare will offer one year of free credit monitoring to affected Georgians who want it.

Carr said that last year, when patient data stored on a CD was lost in the mail, the Department of Community Health's investigation turned up no result.

Grady gets boost for '08 budget

Financially-troubled Grady Hospital in Atlanta has received a boost, but not as much as officials had hoped for. The Atlanta Journal-Constitution reports the state Department of Community Health will distribute 5.4 million dollars more for next year’s budget than this year. However, the amount is still much less than received in 2006. The federal funds for 2008 are expected to total about 73-million dollars. That is down from the 91-million amount in 2006. Grady is one of a handful of level-one trauma care centers in the state.

Proposed funding could benefit Grady Hospital

The Department of Community Health is working on opening a source of federal funding to more hospitals. But the plan could end up hurting rural or local hospitals if it goes forward, according to a report appearing in the Florida Times-Union.

The proposal would make 33 more hospitals eligible for the payments and give Atlanta’s Grady Hospital about $4.8 million more.

The changes being discussed are for the Disproportionate Share Hospital program, in which the state distributes over $250 million in federal aid to hospitals. This is meant to make up for low reimbursement rates for Medicaid patients and the uninsured.

However, since the program is not expected to grow, it could cost other facilities in the state an average of 3.3 to 3.6% of what they would otherwise have received, according to the report.

A final vote is scheduled for November 8.

Click here for more GPB coverage of Grady Memorial Hospital, and here for other health news.

Increased Medicaid payments could give hospitals much-needed boost

The state agency in charge of Medicaid wants to take advantage of an enrollment slowdown to increase payments to doctors and hospitals.

Years of low reimbursements have left many providers of health care to Medicaid and PeachCare patients in the red.

Trauma care hospitals have suffered the most. Atlanta's Grady hospital has partially attributed its financial crisis to this situation.

In recognition, the Department of Community Health plans to reimburse them at a higher rate than other hospitals.

State fines managed care group for the poor

The state is fining one of its new Medicaid managed care organizations $3.7 million for failing to provide timely patient care.

An audit by the Georgia Department of Community Health found Peach State Health Plan was slow in granting Medicaid families and Peachcare kids permission to receive medical services.

Agency spokesperson Amanda Seals says DCH stands by its year-old privatized managed care program and will work with Peach State.

"The Department takes their obligations very seriously," says Seals. "But, we also still feel that these plans are doing a better job of managing health care and improving the health outcomes while getting a better value for the state dollar."

Peach State is appealing the fine. In the meantime, it has replaced its top executive. The company provides health services for nearly 280 thousand poor and working-class Georgians.

Medicaid recipients' information still lost in mail

A Georgia Department of Community Health contractor says a disc containing data on nearly three million former and current Medicaid recipients is still missing.

It has been three months since Affiliated Computer Services sent the disk by two-day mail, and discovered it never reached its destination.

"To date, despite Herculean efforts to find it, the CD has not been found. ACS regrets this, as do I," company vice president John Hammock told the Board of Community Health at a meeting Thursday.

Hammock admits "a mistake was made" when the company failed to encrypt the sensitive information before mailing it. But, he says, there is no evidence the data has been misused.

The state has not canceled its contract with ACS.