If lawmakers had a case of the Mondays, they certainly did not show it, returning to the Capitol for Legislative Day 21 today with a full slate of substantial business. Legislators started the day by passing the first Certificate of Need legislation out of the House Special Committee On Access to Quality Health Care, setting up HB 198 for its next fight in the Rules Committee before it makes it to the floor. Speaking of the House floor, all eyes were on Speaker David Ralston (R-Blue Ridge) who, in an impassioned speech from the well, addressed critics and their allegations of unethical use of legislative leave and committed to squelch any further concerns by creating a bipartisan advisory group to examine legislative leave and personally taking no additional criminal cases as an attorney while he serves as Speaker. And that just gets us to the Rules Calendars in the House and Senate. Check out today’s floor action, as well as the full afternoon of committee meetings in today’s #GoldDomeReport.

In this Report:

• House Approves Psychology Interjurisdictional Compact, Other Bills
• Senate Passes School District Audit Exception Bill
• Committee Updates
• New Legislation
• Rules Calendars for Legislative Day 22

House Approves Psychology Interjurisdictional Compact, Other Bills

Among the eight bills considered by the House today was one focused on expanding the availability of mental health services in and around the state. HB 26, authored by Rep. Dave Belton (R-Buckhead), is the “Psychology Interjurisdictional Compact” ("PSYPACT"). PSYPACT allows for psychologists in states in which it is adopted to practice telepsychology across state lines and also provides limited in-person practice authority. Rep. Belton described the bill as a way to help the state be more military-friendly (by giving military spouses the ability to continue to practice psychology when moving to Georgia) but also a way to deploy more mental health services in rural areas. Rep. David Knight (R-Griffin) expressed concern about the ability of the State to punish bad actors practicing in Georgia through PSYPACT, to which Rep. Belton noted that the State’s Board of Psychology Examiners would have full ability to sanction PSYPACT practitioners in the state. Rep. William Boddie (D-East Point) asked whether issues with the bill brought up in the Rules Committee had been addressed, to which Rep. Belton noted that concerns had been allayed. The House then voted to approve the bill by a 169-1 vote. The bill now moves to the Senate for consideration.

The House also took up two other bills of particular interest:

• HB 70, authored by Rep. Chuck Efstration (R-Dacula), amends Title 29 to revise provisions relating to guardians and conservators of minors and adults. The bill was approved by the House by a 170-0 vote.
• HB 85, authored by Rep. Penny Houston (R-Nashville), amends Title 48 to exempt non-profit organ procurement organizations from sales and use tax. The bill also creates a reporting requirement for organ procurement organizations to submit annual reports including number of donors and transplants facilitated by the organization in the previous fiscal year. The bill was approved by the House by a 171-1 vote.

Senate Passes School District Audit Exception Bill

By a 53-1 vote today, the State Senate adopted SB 68, Sen. Freddie Powell Sims’s (R-Dawson) bill aimed at strengthening provisions relating to the financial management of local school systems. The bill incorporates the work of the Senate Study Committee on Continual Audit Exceptions on Local School Systems from the summer and fall of 2018. Specifically, the bill provides for training for local board of education members and local school superintendents on financial management; monthly reporting to the local board of education on the financial stability of the local school system; designation by the Department of Audits and Accounts of high-risk local school systems and moderate-risk local school systems based on annual audits; and financial management provisions in flexibility contracts and system charters. The bill now heads to the House for consideration.

Committee Updates

House Special Committee On Access to Quality Health Care

The House Special Committee On Access to Quality Health Care, chaired by Rep. Richard Smith (R-Columbus), met this morning to take action on HB 198, Rep. Matt Hatchett’s (R-Dublin), comprehensive Certificate of Need (“CON”) repeal and replacement. Rep. Hatchett presented a substitute to the bill (identified as LC 33 7787S) and noted the two changes from the prior version heard by the Committee: (1) on line 2141, the burden of proof to challenge issuance of a special health service license is changed from “clear and convincing evidence” to “a preponderance of the evidence”; and (2) on lines 2166-73, the language has been changed to allow a physician to count indigent and charity care provided outside of an ASC in which he or she has an ownership interest toward that ASC’s indigent and charity care requirement up to the percentage of the physician’s ownership interest. Chairman Butch Parrish (R-Swainsboro) asked if there may be more changes to the bill and additional “scrubbing” in the legislative process. Chairman Smith indicated additional work is expected as the bill proceeds and that Senate health leaders have already met to discuss potential compromise. Rep. Hatchett moved that the bill DO PASS, and the Committee voted by an apparent 7-4 margin to pass the bill on to the Rules Committee.

House Education Committee -- Academic Support Subcommittee

Rep. Wes Cantrell’s (R-Woodstock) Academic Support Subcommittee of the House Education Committee heard two bills today. The first, HB 12, was presented by Rep. Rick Williams (R-Milledgeville). This bill requires all public schools to post a sign containing the toll-free number operated by the Division of Family and Children Services of the Department of Human Services to receive reports of child abuse and/or neglect. Rep. Williams explained that this bill was designed to help children struggling with bullying or abuse to understand that it is ok to ask for help. Members of the committee expressed their support for the measure, which received a unanimous recommendation DO PASS. The committee then heard HB 1, by Rep. Jesse Petrea (R-Savannah), which would rename the Georgia Special Needs Scholarship the Senator Eric Johnson Scholarship. The bill received a quick recommendation DO PASS and the subcommittee adjourned. 

House Human Relations and Aging Committee

Rep Vance Smith (R-Pine Mountain) presented HB 300 and outlined the change in the law.  Current law refers to “continuing care retirement communities” and this legislation makes the changes so that “ retirement” and “care” are stricken from current law and will be called “Life Plan Community.”  Leading Age of Georgia has asked for this bill.   The changes are made in Chapter 6 of Title 31 and Chapter 45 of Title 33.  There were some questions regarding the costs associated; Leading Age’s members have asked for bill.  There are 13 life plan communities in Georgia.  Rep. Park Cannon (D-Atlanta) asked for the statistics.  Jennie Helms indicated that a nationwide study was done and the folk did not like the stigma with the terms of retirement and care and they asked for the change.  Rep. Cannon asked for the study as well as information from state members to Leading Age on this issue.  Tom Bauer also spoke to the bill; the Department of Insurance also indicated, per Mr. Bauer, that the Department had no issues with the legislation. The bill received a DO PASS recommendation; however, a motion was made to reconsider so as to make an amendment at line 30 after the word “some” strike “or” and insert a comma so as to read payable in the lump sum, monthly charges or installments.  The amendment received a second and was adopted.  HB 300 then received a DO PASS as amended.

HB 374, by Rep. John LaHood (R-Vadlosta).  It was LC 33 7784S, a Committee Substitute. The bill seeks to address assisted living communities, allowing individuals to age in place.  Medication administration is sometimes difficult (especially liquid morphine).  DCH made a determination that certified medication aides were not working within their scope with the hospice patients being served.  Senior living association, hospice, providers and the Department of Community Health worked on the substitute.  It does have hospice oversight.  The licensed provider will administer the first dose and then the certified medication aides can administer the medication when hospice staff is not on sight.  Residents will not have to wait long periods of time for pain relief that was ordered by a physician. Rep. LaHood outlined the differences between nursing homes, personal care homes and assisted living facilities. The morphine is administered sublingual. The question was about whether there was “clinical judgment” required. Thus, the statute is being required to be changed. Line 61 “as needed”  PRN is an as needed when certain signs or symptoms are manifesting. Certified medication aides will be following a physician’s order and who is trained by skilled staff.  DCH Brandy Sylvan spoke to the bill and thanked Reps. LaHood and Petrea for bringing the Department into the conversations.  If oral, then why  - it was about clinical judgment and whether the dosage was appropriate and how the patient is reacting to the medication.  Currently, only RNs may administer morphine.  If the patient was at home, it would also be done by the family and this just replicates that activity. The bill received a DO PASS recommendation and that motion carried.  No changes were made.

House Insurance - Life and Health Subcommittee

This Subcommittee, chaired by Rep. Darlene Taylor (R-Thomasville),  took up two bills:

• HB 323 - Rep. David Knight (R-Griffin) presented this legislation addressing pharmacy benefit managers and prohibited activities by these entities.  It does exclude a closed panel health maintenance organization from the changes.  It clarifies and strengthens mail order provisions and addresses rebates. It prohibits self-referrals.  It does address dispensers, applying to all dispensers in Chapter 64 in Title 33.  He spoke in part to the clawback provisions (amount over the cost of the drug).  The legislation LC 33 8701S is about transparency. Rep. Viola Davis (D-Stone Mountain) asked about page 3 of the bill at line 74 - should be misrepresentation to a pharmacist. Greg Reybold with the Georgia Pharmacy Association and strongly supported the legislation and adds additional protections as this bill strengthens the law passed two years ago addressing pharmacy benefit managers. Motion DO PASS as amended at line 74. Bill moves forward.
• HB 227 - Rep. Spencer Frye (D-Athens) presented LC 46 0056 adding sexual assault so that such are addressed in policies in O.C.G.A. 33-6-4(b)(15).  38 states have adopted similar language.  Page 4 at lines 120-121 was brought to attention of the author and the notice requirements. “Or sexual assault” would be stricken.  No one spoke to the bill. A motion was made DO PASS as amended.

Senate Education & Youth Committee

The Senate Education & Youth Committee, chaired by Sen. P.K. Martin IV (R-Lawrenceville), met to hear two bills today:

• SB 60, authored by Chairman Martin, is intended to help educate coaches and teachers about the threat of sudden cardiac arrest. The bill requires schools to post information on the warning signs of sudden cardiac arrest, hold an informational meeting for parents, and obtain informed consent before participation in sports. The bill also creates a protocol for responding to students who faint or pass out while participating in sports, and it requires medical clearance before a student who passes out or faints returns to participation. Chairman Martin discussed a proposed amendment that would limit liability for school officials that he noted he would offer when the bill was voted upon by the Committee. Sen. Ellis Black (R-Valdosta) notes that the bill does not require a physician to provide the medical clearance for a student to return to participation, and Chairman Martin indicated a willingness to amend his proposition to require a physician clearance. The bill was held for action at a later meeting.
• SB 83, authored by Sen. Jeff Mullis (R-Chickamauga), expands the curriculum that public schools may offer relating to the Bible and other religious texts. Georgia law currently allows courses in Old Testament and New Testament history and literature, and this bill would expand available courses to those relating to law, morals, government, art, music, culture, and custom from religious texts. The bill was reviewed as a hearing only, so the Committee deferred action on the bill until Wednesday.

Senate Insurance and Labor Committee

This Committee took up four pieces of legislation this afternoon:

• SB 142 - This bill received a DO PASS recommendation from the Committee.  It is by Sen. Larry Walker, III (R-Perry) and requires a statement be included on health insurance cards that the health insured’s policy is fully insured. This would mean that all insurance benefits payable are guaranteed under a policy or contract.
• SB 132 and SB 133 - These pieces of legislation are two Insurance Code clean up and update bills.  Both are authored by Sen. Marty Harbin (R-Tyrone) and also received DO PASS recommendations from the Committee.
• SB 156 - Sen. P.K. Martin (R-Lawrenceville) authored this initiative which actually passed the House and Senate in 2018 but was vetoed by Governor Deal.  The legislation permits a domestic insurer to divide into two or more resulting insurers.  The Commissioner of the Department of Insurance would have to authorize such action.  The legislation outlines the standards which must be followed for an insurer taking such action. Resulting entities would be required to be financially solvent on their own merits. Stacy Freeman spoke on behalf Munich American Reinsurance Company in support of the legislation.  Mr. Freeman noted that this legislation has passed in seven other states and is pending in three more states. This bill received a DO PASS recommendation to the Committee Substitute.

Senate Health and Human Services Committee

The committee heard two House bills today, both by Rep. Deborah Silcox (R-Sandy Springs). First was HB 166, which is the “Genetic Counselors Act”. The bill amends Title 43 to authorize the licensure of genetic counselors. Rep. Silcox brought a genetic counselor who practices at Northside hospital to explain to committee members what genetic counselors do and why they are seeking a licensure process from the state. Currently genetic counselors, who engage in a variety of specialties, cannot order genetic testing without the authorization of a physician. She further explained that genetic counselors receive similar amounts of education as nurse practitioners. Sen. Lester Jackson (D-Savannah)  inquired about the current status of training programs in Georgia and Sen. Dean Burke (R-Bainbridge) asked if there are currently issues arising from lack of uniform licensure. Sen. Nan Orrock (D-Atlanta) offered an amendment to fix a grammatical issue which passed. This was followed by Chairman Ben Watson (R-Savannah) entertaining a motion DO PASS which was passed unanimously.

Rep. Silcox then presented HB 158 which amends Title 49 to require that Medicaid recipients have the same access to antiretroviral treatments used to treat HIV/AIDS as to those included in the formulary established for the Georgia AIDS Drug Assistance Program. Chairman Watson explained the bill would receive a HEARING ONLY. Sen. Burke inquired about the lack of a fiscal note which Rep. Silcox explained arises from the difficulty in estimating the number of expected HIV cases in the future. She also stated that the Department of Community Health has raised concerns about the cost of this program. Sen. Orrock stated that she wants to hear a DCH representative testify to the committee about their concerns because she thinks the need for this spending is inarguable. Seeing no further discussion about HB 158, the committee adjourned.

New Legislation

The following legislation of interest was introduced in the House today:

• HB 434, authored by Rep. Bill Hitchens (R-Rincon), amends Title 20 to provide for immunity from liability for a campus policeman at a private, accredited institution of higher learning  when he or she commits a tort while acting in their scope of duties.  No action could be brought against the officer; rather against the school and it caps recovery ($1million single occurrence; $3 million aggregate). This bill was referred to the House Judiciary Committee.
• HB 438, authored by Rep. Mandi Ballinger (R-Canton), amends Title 15 to prevent a child from being placed in restraints for any court hearing unless the court has issued a ruling finding that restraints are necessary for a specific child. This bill was referred to the House Juvenile Justice Committee.
• HB 439, authored by Rep. Mandi Ballinger (R-Canton), amends Title 15 to require that judges of juvenile courts be elected by electors in the circuit for which they will serve. This bill was referred to the House Juvenile Justice Committee.
• HB 440, authored by Rep. Mandi Ballinger (R-Canton), amends Title 15 to change the jurisdiction of the juvenile court to include children under the age 18. This bill was referred to the House Juvenile Justice Committee.
• HB 441, authored by Rep. Roger Bruce (D-Atlanta), amends Title 15 to create a treatment program within the juvenile court for substance abuse. This bill was referred to the House Juvenile Justice Committee.
• HB 442, authored by Rep. Kim Schofield (D-Atlanta), amends Title 20 to create a grant program for certain physician specialists (who serve patients with complex medical conditions) under the Georgia Board for Physician Workforce. The grants would be $25k per year for up to four years or $100k. There is a requirement for the physician to serve in an underserved area of the state as designated by the Board. The doctors participating would have to be Georgia residents and licensed to practice in Georgia. This bill was referred to the House Appropriations Committee.
• HB 444, authored by Rep. Bert Reeves (R-Marietta), amends Title 20 to rename the “Move on When Ready Act” to the “Dual Enrollment Act.”  It establishes new definitions and permits a ‘covered eligible high school student” the ability to take a maximum of 30 hours of covered dual credit courses (delivered on-site or on-line).  It also permits a student to take noncovered dual credit courses (those after 30 at their own expense or using lottery funds (but counting towards the 190 quarter hour or 127 semester hour caps). This bill was referred to the House Education Committee.
• HB 454, authored by Rep. Kevin Tanner (R-Dawsonville), amends Title 40 to allow motorized mobility devices to be used in bicycle lanes. This bill was referred to the House Transportation Committee.
• HR 327, authored by Rep. Ron Stephens (R-Savannah), proposes an amendment to the Constitution to allow the local authorization for a limited number of licensed destination gambling resorts. This resolution was referred to the House Economic Development Committee.
• HR 345, authored by Rep. El-Mahdi Holly (D-Stockbridge), proposes an amendment to the Constitution to allow citizens who are 17 years of age or older to register to vote, and vote in elections. This resolution was referred to the House Governmental Affairs Committee.

The following legislation of interest was introduced in the Senate today:

• SB 160, authored by Sen. Tonya Anderson (D-Lithonia), amends Title 40 to require that all occupants of a vehicle, regardless of their location in the vehicle, to wear a seatbelt. Current Georgia law allows occupants not in the front seat of a vehicle to not wear a seatbelt. This bill was referred to the Senate Public Safety Committee.
• SB 161, authored by Sen. Lindsey Tippins (R-Marietta), amends Title 20 to require that HOPE Scholarship GPA’s are calculated by weighting certain advanced placement, dual enrollment, and international baccalaureate course. This bill was referred to the Senate Higher Education Committee.
• SB 163, authored by Sen. Bruce Thompson (R-White), amends Title 20 to allow homeschooled students to participate in extracurricular and interscholastic activities sponsored by his/her resident school system. This bill was referred to the Senate Education and Youth Committee.
• SB 164, authored by Sen. Bill Cowsert (R-Athens), amends Title 17 to limit the types of violations of local ordinances that a local court can allow the accused to be released on their own recognizance. This bill was referred to the Senate Judiciary Committee.
• SB 165, authored by Sen. Bruce Thompson (R-White), amends Title 20 to create a designation for a non-profit organization to govern high school athletics for public schools. A private school that wishes to compete with public schools may join the organization. This bill was referred to the Senate Education and Youth Committee.
• SB 166, authored by Sen. Lester Jackson (D-Savannah), amends Title 16 to enact the “Georgia Enhanced Penalties for Hate Crimes Act” to provide for higher penalties for individuals that commit a variety of crimes against a person that is “individually selected because of such individual’s race, color, religion, gender, disability, sexual orientation, gender identity or expression, nation of origin, or ethnicity.” This bill was referred to the Senate Judiciary Committee.
• SB 167, authored by Sen. Matt Brass (R-Newnan), amends Title 15 to provide that after six months of searching for fictive kin by DFCS, if no such kin can be found, the child will remain in the foster home in which they had been placed. This bill was referred to the Senate Judiciary Committee.
• SB 168, authored by Sen. Greg Kirk (R-Americus), amends Title 43 to clarify that individuals holding a multistate license under the Nurse Licensure Compact can practice in Georgia without further licensing requirement. The bill also repeals a portion of the Compact as passed in Georgia (Code Section 43-26-65) that is in conflict with the Compact nationwide. The bill was assigned to the Senate Health and Human Services Committee.
• SB 169, authored by Sen. Bruce Thompson (R-White), amends Title 31 to require that in all cases of chemical abortions the female be informed by telephone or in person at least 24 hours before the abortion procedure that it may be possible to reverse the effects of the chemical abortion if the woman changes her mind. The bill further requires that this same information be available on the state website. This bill was referred to the Senate Health and Human Services Committee.
• SB 173, authored by Sen. Greg Dolezal (R-Cumming), amends Title 20 to establish educational scholarship accounts for children whose family income is less than 200% of the federal poverty level, who have been adopted from foster care, who have an active duty military parent, who have individualized education programs, who have documented cases of having been bullied, or have simply been enrolled in a Georgia public school for the past year. The bill would allow parents of such children to take the public funds allocated for their children’s public education and place those funds in an account that could be used to pay for tuition, fees, and textbooks at private schools, as well as tutoring services, online education programs, and therapy services. This bill was referred to the Senate Finance Committee.
• SB 175, authored by Sen. Ellis Black (R-Valdosta), amends Title 47 relating to the Teachers Retirement System to allow for a beneficiary to return to service as a substitute teacher or an hourly classroom aide without becoming a contributing member again. The bill was assigned to the Senate Retirement Committee.

Rules Calendars for Legislative Day 22

The House is expected to consider the following measures on Tuesday for Legislative Day 22:

• HB 319 -- Georgia Firefighters' Pension Fund; member's benefits payable after death shall be paid to his or her estate when such member failed to designate a beneficiary or his or her designated beneficiaries are deceased; provide (Ret-Williams-148th)
• HB 185 -- Financial institutions; change certain definitions (B&B-Williamson-115th)
• HB 228 -- Marriage; change minimum age from 16 to 17 and require any person who is 17 to have been emancipated (Substitute)(JuvJ-Welch-110th)
• HB 284 -- Cobb County; Magistrate Court chief judge; provide nonpartisan elections (GAff-Carson-46th)
• HB 285 -- Cobb County; probate judge; provide nonpartisan elections (GAff-Carson-46th)
• HB 316 -- Elections; definitions; provide for uniform equipment and ballot marking devices (Substitute)(GAff-Fleming-121st)

The Senate is expected to consider the following measures on Tuesday for Legislative Day 22:

• SB 18 -- "Direct Primary Care Act" (Substitute) (RULES-32nd)
• SB 106 -- "Patients First Act" (H&HS-19th)
• SB 115 -- "Medical Practice Act of the State of Georgia"; telemedicine licenses for physicians in other states; engage in the practice of medicine with patients in this state through telemedicine; provide (S&T-45th)
• SB 118 -- Insurance; Georgia Telemedicine Act; modernize; Telemedicine Act the Telehealth Act; rename (S&T-45th)
• HB 62 -- Margie's Law; enact (H&HS-1st) Cooper-43rd