Tax reform came to Georgia today with Governor Nathan Deal announcing the State’s response to last year’s federal tax reform. HB 918, carried by Deal’s floor leader Rep. Chuck Efstration (R-Dacula), allows Georgia taxpayers to take the increased standard deduction at the federal level and take either standard or itemized deductions at the state level. The legislation also enhances personal exemptions by 25 percent.

The Senate Appropriations Committee passed its version of the Amended FY 2018 Budget today, and House and Senate Health and Human Services committees took up several propositions, including legislation adopting the House Rural Development Council’s healthcare recommendations and expanding the scope of practice for Advanced Practice Registered Nurses in rural areas. Details on both and more in today’s #GoldDomeReport.

In this Report:

• Committee Reports
• New Legislation
• Rules Calendars for Legislative Day 21

Committee Reports

Senate Appropriations Committee

The Senate Appropriations Committee, chaired by Sen. Jack Hill (R-Reidsville), met today and passed out its version of the Amended FY 2018 Budget, HB 683. Notable differences from the House proposal include:

• $1.6M increase for legal services for DHR Child Welfare Services;
• $1.025M increase for DCH’s State Office of Rural Health to develop plans to establish and implement the Health Coordination and Innovation Council and  fund a grant program to encourage health systems to purchase data analytic or electronic/digital population health tools
• $220,000 increase for the DBHDD Albany Resource Center;
• $129,000 increase for DJJ culinary vocational program at Macon YDC;
• $125,000 cut restoration from House version reducing DOE funds for unfilled RTC program manager position;
• $1M reduction of funds added by the House for additional DBHDD crisis center beds;
• $410,000 reduction of funds added by the House for a renovation of the kitchen at DBHDD’s East Central Regional Hospital;
• $173,000 decrease in DPH’s Office for Children and Families; and
• $92,000 partial reduction of funds added by the House for DCH analysis of the Medicaid delivery system.

Chairman Hill noted that he expected the proposal to be on the Senate floor on Thursday.

Senate Health and Human Services Committee

The Senate Health and Human Services Committee, chaired by Sen. Renee Unterman (R-Buford), met today to consider two bills:

• SB 351, authored by Sen. Renee Unterman (R-Buford), expands the scope of practice for advanced practice registered nurses (“APRN”). The legislation allows APRNs primarily working in a county of 50,000 or fewer residents to order computed tomography (CT) scans and to prescribe, procure, administer, dispense, and furnish pharmacological agents, including over-the-counter and controlled substances without the protocol agreements generally required by O.C.G.A §§ 43-34-23 and 43-34-25. Sen. Unterman presented a proposed substitute that addresses concerns about APRN education, requiring any APRN seeking to practice under these provisions to have received a degree from a program that has a supervised patient care clinical component and new APRNs to have collaborative agreement with a practitioner when starting out. Sen. Fran Millar (R-Atlanta) expressed concern about the addition of another group to prescribe controlled substances while the Senate is pushing for opioid control. Senator Unterman noted that she was disappointed that nearly 20% of the physicians in Georgia have not registered with the Prescription Drug Management Program, but is amenable to having the controlled substance section removed.  Georgia Academy of Family Physicians, a representative of Family and Preventive Medicine at Emory, the Georgia Chapter of the American Academy of Pediatrics, the Georgia Society of Anesthesiologists and the Medical Association of Georgia spoke in opposition of the bill citing the discrepancy in training between doctors and nurses and overutilization of the healthcare system and increased costs due to excess prescribing and referrals by APRNs.  Concern was also expressed over whether or not the nurses should be required to have medical insurance.  Several nurse practitioners, including a representative of APRN Independent Practitioners, spoke in favor of the bill and noted that they are required to obtain and maintain rigorous board certification.  They also noted that there is a significant amount of studies and research that prove that APRNs give good, quality, safe care.  Several of the nurses who already work in rural areas expressed fears for when their elderly physicians retire and there is not anyone to replace them in overseeing their practices—which are sorely needed due to the lack of available health care in their areas.  Senator concluded by noting that she wants to work on another committee substitute and requested that the Committee submit suggestions on changes to the bill in writing. 
• SB 325, authored by Sen. Kay Kirkpatrick (R-Marietta), called the "Interstate Medical Licensure Compact Act," was on the agenda, but the Committee ran out of time and will hear it on Thursday.

Sen. Unterman concluded by recognizing the many medical students in the audience and noting that Thursday will be Nursing day as they will vote on both bills under consideration for the Committee at that time.

House Health and Human Services Committee

The House Health and Human Services Committee, chaired by Rep. Sharon Cooper (R-Marietta), met and considered four bills today:

• HB 161, authored by Rep. Betty Price (R-Roswell), provides that persons affiliated with a syringe service program (“SSP”) are not subject to prosecution for certain offenses relating to distribution of hypodermic needles. Rep. Price noted that the bill is intended to assure that individuals have access to clean needles and disposal locations by allowing SSPs to work to curb the spread of disease while providing counseling and testing for those who are using needles. The Committee amended the proposal to require the Department of Public Health to register SSPs whose agents would be exempt from prosecutions. The Committee recommended the bill DO PASS by Committee Substitute and be sent to the Rules Committee.
• HB 473, authored by Rep. Tom Kirby (R-Loganville), criminalizes the willful misrepresentation of a pet as a service dog. Rep. Kirby presented a proposed substitute to the original bill, which provided protections for any service animal for the physically or mentally disabled and allowed for the issuance of an identification card to service animal owners. After numerous concerns from groups including grocers and restauranteurs, Rep. Kirby pared down the bill to cover only service dogs for physically impaired persons. The Georgia Restaurant Association indicated that they were satisfied with the bill. The Committee recommended the bill DO PASS by Committee Substitute and be sent to the Rules Committee. 
• HB 769, authored by Rep. Rick Jasperse (R-Jasper), implements recommendations from the House Rural Development Council relating to health care issues. The bill:
  
  
  • Allows for remote order entry of prescriptions in hospital pharmacies by a Georgia-licensed pharmacist who is physically located out of state. According to Rep. Jasperse, Georgia is the only state to not allow this type of order entry.
  • Requires DCH to take all reasonable steps to streamline and expedite the credentialing and billing processes for state medical plans, including but not limited to examining the potential for a uniform billing platform or portal
  • Establishes the Rural Center for Health Care Innovation and Sustainability within DCH’s State Office of Rural Health.
  • Allows for microhospitals that have 2-7 beds and provide 24/7 services in counties of fewer than 50,000 residents.
  • Calls for the establishment of a grant program to increase the number of physicians who remain in Georgia to practice in medically underserved rural areas of the state
  • Increases the Rural Healthcare Tax Credit from 90% to 100%.

The Georgia Hospital Association spoke in support of the legislation but did not a handful of concerns, including the magnitude of penalties for hospitals with executives or board members who fail to participate in training to be provided by the Rural Center. Piedmont Healthcare, as well as the Georgia Association of Community Hospitals, spoke in favor of the bill and specifically the microhospital provision. The Georgia Society of Health-System Pharmacists spoke to the remote order entry provision, expressing concerns about pharmacists working out of state and asking that the next-business-day review provision be reverted back to 24 hours.

Rep. Ed Rynders (R-Albany) offered an amendment to the bill to make the training and resources from the Rural Center available to anyone rather than restricting it to the required recipients. The Committee recommended the bill DO PASS by Committee Substitute and proceed to the Rules Committee.

• HB 895, authored by Rep. Sharon Cooper (R-Marietta), prohibits the sale of drug products containing dextromethorphan, an ingredient in cough syrup, to individuals under the age of eighteen. Rep. Jesse Petrea (R-Savannah) asked for data on how big of a problem this is, and Rep. Spencer Frye (D-Athens) noted that he believes, anecdotally, that it is prevalent. The bill recommended the bill DO PASS by Committee Substitute and be sent to the Rules Committee.

New Legislation

The following propositions were introduced in the House:

• HB 899, authored by Dominic LaRiccia (R-Douglas), amends Titles 13 and 36 relating to public works contracting to provide that a bidder may not be disqualified on the ground that the bidder lacks prior experience with the delivery method to be used on the project. The bill was referred to the Governmental Affairs Committee.
• HB 903, authored by Rep. Howard Maxwell (R-Dallas), amends Title 47 to prohibit any member who joins or joined the Teachers Retirement System after July 1, 2993, from receiving a postretirement benefit adjustment unless the annual required employer contribution for the preceding fiscal year was less than $150 million and the employee contribution rate is established by the board at 6 percent. The bill was referred to the Retirement Committee.
• HB 905, authored by Rep. David Clark (R-Buford), is the Equal Opportunity for Access to Education Act and amends Title 20 to allow home study students to participate in extracurricular and interscholastic activities in the student's resident public school system. The bill requires a resident school system to allow such participation if such a student meets certain requirements but does allow the system to charge participation fees as allowed in statute. The bill was referred to the Education Committee.
• HB 906, authored by Rep. Katie Dempsey (R-Rome), amends Title 50 to exempt personal information of certain foster parents or former foster parents from disclosure under the Georgia Open Records Act. Exempted information includes a foster parent’s home address, home telephone number, day and month of birth, social security number, insurance or medical information, mother's birth name, and financial information. The bill was referred to the Juvenile Justice Committee.
• HB 908, authored by Rep. Robert Dickey (R-Musella), amends Title 20 to allow for certain individuals who are 20 years old or older to enroll in a state charter school that provides instruction for over-age students. The code section would only be operative if the State Charter Schools Commission approves a state charter school with a state-wide attendance zone for over-age students and would only allow enrollment of individuals until he or she attains a high school diploma or a GED. The bill was referred to the Education Committee.
• HB 909, authored by Rep. Deborah Silcox (R-Sandy Springs), amends Title 31 to allow the Department of Public Health to designate perinatal facilities providing maternal or neonatal care. The legislation requires the department to create designation criteria and procedures, as well as post a list of designated centers. The bill was referred to the Health and Human Services Committee.
• HB 910, authored by Rep. Paulette Rakestraw (R-Hiram), amends Title 16 to criminalize the engagement in sexual extortion. The bill is similar to SB 314, authored by Sen. Harold Jones II (D-Augusta), which is still pending in the Senate. The bill was referred to the Judiciary Non-Civil Committee.
• HB 914, authored by Rep. Don Parsons (R-Marietta), amends Title 40 to clarify when overtaking a stopped school bus is a criminal rather than a civil offense. When observed by a law enforcement officer or school bus driver, the offense shall be considered a misdemeanor, but when the violation is recorded by camera, it will be treated as a civil offense subject to a civil penalty. The bill was referred to the Ways and Means Committee.
• HB 915, authored by Rep. Lee Hawkins (R-Gainesville), amends Titles 16, 42, and 48 to provide for the regulation and licensure of bodywork therapists. The bill was referred to the Regulated Industries Committee.
• HB 916, authored by Rep. Jonathan Wallace (D-Watkinsville), amends Title 33 to change certain standards applicable to the making and use of motor vehicle insurance rates. The bill was referred to the Insurance Committee.
• HR 1115, authored by Rep. Mandi Ballinger (R-Canton), recognizes February 14, 2018, as Georgia Court Appointed Special Advocate Day at the Capitol.
• HR 1116, authored by Rep. Michele Henson (D-Stone Mountain), recognizes and commends Normer Adams.
• HR 1127, authored by Rep. Derrick Jackson (D-Tyrone), recognizes February 21, 2018, as Substance Abuse Prevention Day at the Capitol.

The following propositions were introduced in the Senate:

• SB 413, authored by Sen. Michael Williams (R-Cumming), amends Title 21 to prohibit any member of the Governor’s senior staff from registering and acting as a lobbyist and from being hired as a consultant by any agency or entity of the executive branch of state government for a period of two years following the termination of such individual's employment. The bill was referred to the Ethics Committee.
• SB 415, authored by Sen. Lindsey Tippins (R-Marietta), amends Title 43 to require nursing homes to have backup power sources in the event of power outages. Such sources must be capable of providing power to the entire facility to provide lighting in all patient rooms, common areas, exits, stairs, and corridors; to maintain critical safety systems such as telephones, fire detection, and suppression systems; to operate HVAC systems to maintain safe temperatures for the protection of patients; to operate refrigeration units for safe handling of food and medications; and to support all essential services for patients. The bill was referred to the Regulatory Industries and Utilities Committee.
• SR 756, authored by Sen. Chuck Hufstetler (R-Rome), recognizes February 13, 2018, as Physical Therapy Day at the Capitol.
• SR 761, authored by Sen. Fran Millar (R-Atlanta), establishes a Senate Study Committee on Dyslexia. Such Committee would be composed of three members of the Senate to be appointed by the President of the Senate and two members appointed by the Governor, one of whom shall be an employee of the Department of Education and one of whom shall be a medical doctor with a specialty in dyslexia.
• SR 768, authored by Sen. Steve Gooch (R-Dahlonega), recognizes February 14, 2018, as Georgia Court Appointed Special Advocate Day at the Capitol.

Rules Calendars for Legislative Day 21

The House will take up 8 propositions tomorrow:

• HB 190 -- Domestic relations; marriage articles and antenuptial agreements; change provisions
• HB 302 -- Ad valorem tax; property; change certain requirements to notice pertaining to millage rate adoption
• HB 740 -- Education; local school system to conduct certain screenings, assessments, and reviews prior to expelling a student; require
• HB 749 -- Income tax; retirement income is applicable as a retirement benefit from noncivilian service in the United States armed forces; clarify an exemption
• HB 767 -- State government; verification of lawful presence that may be utilized in conjunction with electronic filing of an application for unemployment insurance; provide
• HB 789 -- Labor and industrial relations; marketplace contractors to be treated as independent contractors under state and local laws; provisions
• HB 800 -- Workers' compensation; eligibility for appointment as director emeritus and administrative law judge emeritus; change certain provisions
• HR 158 -- General Assembly; provide for dedication of revenues derived from fees or other taxes to the public purpose for which such fees or other taxes were imposed; authorize - CA
• HR 898 -- Joint Study Committee on the Establishment of a State Accreditation Process; create

The Senate will take up seven bills on Wednesday:

• SB 107 – Ethics in Government; filing campaign financial disclosure reports; additional date prior to general primary; revise the dates
• SB 248 – Life Insurance; life insurers’ requirement to review the National Association of Insurance Commissioners life insurance policy locator; provide
• SB 348 – Technical College System of Georgia; powers of arrest of campus policemen who are regular employees; revise
• SB 366 – Local Government; counties and municipal corporations to perform wage and compensation studies for employees of sheriff’s office; require
• SB 367 – Payment of Indemnification for Death or Disability; option of payment to an estate in the case of death; law enforcement officer; firefighter; emergency medical technician, emergency management specialist, state highway employee or prison guard; provide 
• SB 368 – Criminal Justice Coordinating Council; functions and authority; add
• SB 369 – Revenues Collected from Fines and Fees; payments to Peace Officers’ Annuity and Benefit Fund; fees collected in criminal and quasi-criminal cases prior to adjudication of guilt; provide