It’s 5PM under the Gold Dome, but there is no sign of legislative action slowing. Today marks Legislative Day 28, known as Crossover Day and the last day a bill can emerge from the House or Senate and still be considered in the opposite chamber before the General Assembly adjourns Sine Die. As such, legislators will work late into the night to keep their bills and resolutions alive. The House and Senate have already had long debates and votes on substantial propositions today, including a House rejection of major Certificate of Need reform (HB 198, lost by a 72-94 vote, pending reconsideration) and a Senate sign-off on the State taking over control of the Atlanta Airport (SB 131, passed by a 24-22 vote). Notably, however, the Senate declined to reconsider SB 173, the school voucher proposition that failed in the Senate on Tuesday. Nevertheless, much more action is ahead, and we’ll be here until adjournment to keep track of the yeas and nays--follow along with us on Twitter with the hashtag #GoldDomeReport. In the meantime, catch on what has happened so far in today’s Report below.

In this Report:

• House Rejects Certificate of Need Reform
• Dual Enrollment Reform Passes House
• Senate Approves Computer Science Curriculum Requirement
• Notable Bills in House
• Notable Bills in Senate           

House Rejects Certificate of Need Reform

After debate largely dominated by pro-reform legislators, the House voted today to reject HB 198, Rep. Matt Hatchett’s (R-Dublin) comprehensive Certificate of Need reform measure by a vote of 72 to 94. However, a successful motion for reconsideration keeps the bill alive with the potential for another vote before the legislature adjourns today.

Before the vote, Rep. Hatchett outlined the legislation for House members, noting that it addresses many aspects of CON but does not repeal the CON process. He noted that it does make it illegal to sell a CON (“medical use rights”), and the Rural Hospital Tax Credit is included in the legislation with new requirements for this credit. The bill would also allow the 25 most needy hospitals to avoid penalties on the indigent care portion. Rep. Hatchett fielded questions from a number of members:

• Rep. Mark Newton (R-Augusta) asked whether increased competition could lead to higher quality and lower costs? Rep.Hatchett said he could not have said it better and that the transparency provisions are vital signs that are needed to look for better solutions for Georgia families.
• Rep. Don Parsons (R-Marietta) asked about Legacy Sports and its CON status. Rep. Hatchett explained that the facility had obtained a CON but it had been challenged.  Rep. Parsons also asked about the 35 mile appeal process limitation, and Rep.Hatchett explained the current appeal process, where any other entity can now object. This bill limits objection area to 35 mile radius asking for a CON.
• Rep, Tommy Benton (R-Jefferson) ask isn’t it not true that facilities would not cherry pick the paying services and leave hospitals with more indigent and charity care patients.
• Rep. Tom Kirby (R-Loganville) asked about CTCA asked about its conversion, specifically asking if it would be able to take more Georgians. Yes, that would take place per Rep. Hatchett.

Several members also spoke in favor of the bill:

• Rep. David Stover (R-Newnan) spoke to the legislation, noting that he offered bills to eliminate CON and asked for the House to vote for the changes and the bill moves the State “down the road.” He pointed to the Newnan situation and each time they attempted to add a service the Atlanta hospitals opposed those requests. Clinics in their area have been bought by hospitals driving the cost of healthcare up in his area. Rep. Stover stated that he believes that they force doctors into these agreements. He pointed to Albany and its purchase of facilities; and he pointed out their offshore accounts in the Cayman Islands but have tons of “cash sitting around.” They have to use their money as a nonprofit entity. They should be limited to what can be charged patients. Rep Stover noted that CON is killing our state and access to healthcare and it is driving costs through the roof.
• Rep. Penny Houston (R-Nashville) stated that she has seen rural hospitals continue to close despite CON. Her folks do not have $2 million in ads to work on something to benefit them. They need disclosure.
• Rep. Terry England (R-Auburn) indicated this legislation was six years' worth of work, trying to figure out how to help rural hospitals survive in today’s world. CON has not helped a rural hospital from closing. To update equipment (like MRI), to help with diagnoses, because of spending cap the rural hospital has to apply for a CON for that equipment.  Same thing for beds or new line of service, they must apply for a CON.  To add mental health beds, they must apply for a CON - that should not be the case.  Those services should be available in the community where they are needed.  He argued that mental health beds could be added in rural areas where those acute beds could be changed to psychiatric/mental health beds. Hospital EDs are not money makers; they ran a model to determine cost of a free-standing ED.  It is a $1.5 million loss leader per year according to Rep. England. The math shows it is not a profit center but increased access to healthcare - whether in Atlanta or McRae. He asked folks to vote in favor of the bill to move healthcare further into the 21st century.  Rep. Newton asked Rep. England that they have heard from hospital administrators - with regard to yes or no vote - they have a choice and that a yes vote will allow the legislators to look at a constituent that they are trying to move the process down the road to lower healthcare costs. Rep. Buckner asked about freestanding cardiac centers - is the same patient quality the same as in the hospitals for those services? To be licensed in the State, they have to meet the same quality metrics.  He was open to tweaks on the quality measures to bring into parity with what the hospitals do.  Rep. Buckner said that would be good as that is of concern to many hospitals across the state.  Rep. Wilensky asked about the goal of the legislation and in particular the 25 most needy hospitals.  Rep. Wilensky was told that fines would be increased for 20 hospitals who do not meet the requirements.

Rep. Hatchett closed debate, noting that he tried to change CTCA five year ago. He stated that he has no relationship with the hospital but thinks that if he lives in Georgia he should be able to go there. Last year, an organization asked for help to address HMOs’ issues and the hospitals refusal to work with the HMO, and the hospitals said no. The House Rural Development Council has looked at the issues, including CON, transparency and Rural Hospital Tax Credit. The legislation has compromises. No rural hospital should object to the bill; this bill is protecting them. The Hospital Tax Credit has transparency and raised the amount to $100 million to help those rural hospitals but substitute lowered it to $60 million but hospitals.  An amendment on the desk takes it back to $100 million.  The bill is about transparency. We can’t help unless we know how bad it is per Hatchett.  Several hospitals make millions and have billions in reserves.  For profit hospitals have to be accountable to stockholders; nonprofit hospitals’ stockholders are “constituents and patients.” 

AM 33 1871 was presented, taking the Rural Hospital Tax Credit to $100 million, and the amendment was adopted by a 99-71 vote.  On the previous question, Reps. Deborah Silcox, Darlene Taylor, Martin Momtahan, and Micah Gravley asked to be excused from the vote under Rule 133. The House rejected the bill by a 72-94 vote, but Rep. Hatchett quickly moved to reconsider. That motion prevailed, which places the bill back on the calendar and makes it eligible for one more up-or-down vote. As of our deadline, the bill had not yet been called up for another vote, but we will track any further action on the bill on Twitter under #GoldDomeReport.

Dual Enrollment Reform Passes House

The House voted this afternoon to accept Governor Kemp’s proposed reforms to Georgia’s Dual Enrollment program, which allows high school students to take postsecondary courses at no charge. 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). The bill was presented as a substitute that provides (among other things) for counseling at the beginning of dual enrollment, the 15 hour mark, and the 30 hour mark; and raises the maximum hours in a semester to 16. Through Whip William Boddie (D-East Point), the minority party expressed concerns about the bill which were countered by majority questioning. Rep. Rick Jasperse (R-Jasper), Chair of the Education Committee that vetted the bill, urged members to support its passage. On the previous question, proponents prevailed, sending the bill to the Senate on a 99-72 vote.

Senate Approves Computer Science Curriculum Requirement

After a long delay caused by the chamber’s debate on Sen. Burt Jones’s (R-Jackson) proposition to exercise State control over the Atlanta Airport, the Senate made quick work of approving Sen. P.K. Martin IV’s (R-Lawrenceville) proposition instituting a computer science curriculum requirement for middle and high school students. SB 108, authored by the Chair of the Senate Education and Youth Committee in collaboration with the Lieutenant Governor’s office, , amends Title 20 to introduce computer science course requirements to the state curriculum for middle and high schools. The bill requires school districts to implement the courses on a 3-year timeline, which has been pushed back a year for all date requirements from the initial bill. Under the substitute, beginning in the 2022-2023 school year, each local district must have at least one high school with a computer science course and must have exploratory computer science courses in every middle school. Beginning in the 2023-2024 school year, local districts must have computer science courses in 50% of their high schools. Local districts must have computer science courses in every high school beginning in the 2024-2025 school year. Additionally the bill requires that the Department of Education must have computer science courses offered via the Georgia Virtual School. The bill also has a focus on ensuring teachers have the professional development needed to offer the courses and implementation of the courses is dependent on appropriations. The Senate voted 51-1 to approve the bill and send it to the House for consideration.

Notable Bills in House

The House took up the following notable propositions as of our deadline today:

• HB 83, authored by Rep. Demetrius Douglas (D-Stockbridge), amends Title 20 to require elementary schools to schedule recess for children in grades K-5 and provides definitions for acceptable forms of recess. The House passed the bill by a 160-11 vote, and it moves on to the Senate for further consideration.
• HB 91, authored by Rep. Andy Welch (R-McDonough), amends Title 31 to allow the Georgia Bureau of Investigation to retain fingerprint records for participants in the Georgia Long-Term Care Background Check Program for purposes of the federally-authorized Rap Back Program. The Rap Back Program allows for continual background checks rather than only a single background check at time of hire. The House passed the bill by a 168-3 vote, and it moves on to the Senate for further consideration.
• HB 168, authored by Rep. Darlene Taylor (R-Thomasville), amends Title 48 to extend a tax exemption regarding the sale or use of tangible personal property to certain non-profit health centers for an additional 5 years. The House passed the bill by a 164-1 vote, and it moves on to the Senate for further consideration.
• HB 311, authored by Rep. Andy Welch (R-McDonough), amends Title 23 to waive sovereign immunity in certain situations. The House passed the bill by a 168-4 vote, and it moves on to the Senate for further consideration.

Notable Bills in Senate

The Senate took up the following notable propositions as of our deadline today:

• SB 110, authored by Sen. Jesse Stone (R-Waynesboro), amends Title 15 to establish the State-wide Business Court pursuant to the Constitution. The Senate passed the bill by a 52-2 vote, and it moves on to the House for further consideration.
• SB 121, authored by Sen. Larry Walker (R-Perry), amends Title 16 to increase the length of time that prescription information is retained in Georgia’s Prescription Drug Monitoring Program from two years to five years. The Senate passed the bill by a 51-1 vote, and it moves on to the House for further consideration.
• 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. Sen. Elena Parent (D-Atlanta) offered an amendment to the bill that would require such students to participate in at least some courses at a local public school in order to be eligible to participate in other activities. The amendment failed, but the bill passed by a 35-19 vote, and it moves on to the House for further consideration.
• SB 190, by Sen. John Kennedy (R-Macon), seeks to make changes to Georgia’s Child Custody Intrastate Jurisdiction Act in Chapter 9 of Title 19.  It provides that a party may bring a counterclaim for contempt or enforcement of a child custody order or for modification of legal (which is the responsibilities for major decisions concerning the child, including but not limited to the child’s education, healthcare, extracurricular activities and religious training) or physical custody in response to a complaint seeking a change of legal or physical custody. The Senate passed the bill by a 52-0 vote, and it moves on to the House for further consideration.
• SB 225, authored by Sen. Larry Walker (R-Perry), amends Title 15 to bring its provisions in conformity with the federal Social Security Act and the Family First Prevention Services Act. The bill also exempts proceedings relating to termination of parental rights subject to the Indian Child Welfare Act from state law and requires that children being discharged from foster care at age 18 be discharged with proof that he or she was previously in foster care. The Senate passed the bill by a 51-0 vote, and it moves on to the House for further consideration.