Piedmont Ellijay’s freestanding emergency room was discussed during last year’s House Rural Development Council meetings around the state. Here, lab technician Mitzi Beavers examines a blood sample on the second day the facility was open in early April. (Photo by Michael Andrews/Mountain Life Editor)

House panel urges big changes to stop decline of rural health care

(Ed. note: This article is taken from a lengthy story on The Pulse, the enewsletter of georgiahealthnews.com.)

An influential task force of Georgia House members has approved a set of bold proposals to bolster rural health care in the state. The recommendations from the House Rural Development Council include expanding insurance coverage through a Medicaid “waiver’’ project and making a fundamental change in the state’s licensing laws known as Certificate of Need (CON).

The report’s proposals, approved in mid-December, also include streamlined billing for health care services; requiring nursing homes to have telemedicine capability; and allowing expanded responsibility for health care providers who are not physicians.

The CON proposal, in particular, is already generating rumblings within Georgia’s hospital industry. The CON laws, though relatively little known to the general public, play a big role in how the state’s health care business operates.

Rural health care problems have become a prime focus of Georgia political leaders over the past few years. One big issue is the constant financial trouble afflicting rural hospitals. Six rural hospitals have closed in Georgia since the beginning of 2013, though two of them have reopened as downsized facilities.

State Rep. Terry England (R-Auburn), co-chairman of the group, said at the council’s December meeting in Milledgeville that health care was “the No. 1 topic we’ve heard throughout the state and [in] all our meetings.’’

All the issues troubling rural Georgia are intertwined, England noted. But he declared, “If health care is not available in a rural area, economic development will never happen.’’

The report expressed the woes of rural Georgia in stark terms.

“In addition to the aging of rural Georgians, rural populations on the whole are sicker, have less or no access to prevention and services, are more likely to suffer from mental illness and chronic diseases, have higher rates of teen pregnancy and higher mortality rates,’’ it said.

The task force’s proposals will now go to the Georgia General Assembly for consideration. It convenes next month.

Jimmy Lewis, CEO of HomeTown Health, an organization of rural hospitals in the state, called the council’s recommendations “an outstanding initiative whose time has come.’’

“This puts the issues on the table,’’ he said, adding that adopting the recommendations could slow down the trend of rural hospital closures. Lewis also said more broadband coverage would help connect patients in their homes with monitoring from health care providers.

One council proposal expected to generate opposition involves the CON process. The regulatory apparatus that governs where health care facilities can be built and what services they can offer has sparked annual battles in the General Assembly.


Piedmont’s Ellijay facility

The recommendations on CON include facilitating what the council called “microhospitals,’’ with limited beds and 24/7 care. An example is the Piedmont Healthcare facility in Ellijay, which is basically a freestanding emergency room, but with links to a full-service hospital in nearby Jasper.

The biggest change would create a two-tiered system for CON. The first would keep the regulations in place for service areas of 85,000 people and below, protecting rural hospitals from competition by surgery or imaging centers.

But for areas above that population threshold, CON would essentially go away for hospitals and organizations.

Monty Veazey, president of the Georgia Alliance of Community Hospitals, said in a statement Thursday, “We appreciate the House Rural Development Council’s hard work throughout this past year to identify solutions to assist rural Georgia and are glad to see recommendations such as the expansion of broadband that could play a role in expanding access to care. We are concerned that the proposal to change Certificate of Need laws in urban areas could have an adverse impact on hospitals not only in rural Georgia, but throughout our state as they struggle to maintain expensive services such as emergency medicine and neonatal intensive care. As such, we oppose any changes to Certificate of Need.”

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